PETERSON DERMATOLOGY, P.C.
Osteopathic Medicine at 1 St, Vidalia, GA

License number
Georgia 058913
Category
Osteopathic Medicine
Type
Dermatology
License number
Georgia 058913
Category
Osteopathic Medicine
Type
Pediatric Dermatology
License number
Georgia 058913
Category
Osteopathic Medicine
Type
Procedural Dermatology
Owner
Name: DR. LETTY REVELL PETERSON M.D.
Title: DERMATOLOGIST
Phone: (912) 538-9080
Address
Address
305 W 1St St, Vidalia, GA 30474
National Provider ID: 1932300886
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PETERSON DERMATOLOGY, PC

405 Woodbridge Cir, Vidalia, GA 30474

Registration:
Apr 24, 2007
State ID:
07038575
Business type:
Domestic Profit Corporation
Secretary:
Revell Letty Peterson (Secretary), 305 1 St W, Vidalia, GA 30474 (Physical)
Agent:
Letty Revell Peterson,405 Woodbridge Cir, Vidalia, GA (Physical)

Peterson Dermatology PC

1707 Mdw Ln, Vidalia, GA 30474

Industry:
Medical Doctor's Office
Manager, Principals:
Letty R. Peterson (Dermatology),Rita Neesmith (Medical Assistant),Rosa Coxwell (Medical Assistant),...

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