PETERSON PT LLC
Medical Practice at Iron Springs Rd, Prescott, AZ

License number
Arizona 5079
Category
Medical Practice
Type
Sports Medicine
License number
Arizona 6499
Category
Medical Practice
Type
Sports Medicine
License number
Arizona 5810
Category
Medical Practice
Type
Sports Medicine
Owner
Name: MR. BREK LAMONT PETERSON PT
Title: OWNER
Phone: (928) 771-2977
Address
Address
1320 W Iron Springs Rd, Prescott, AZ 86305
National Provider ID: 1669480968
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about PETERSON PT LLC at bizstanding.com

PETERSON P.T., LLC

1450 Iron Spg Rd, Prescott, AZ 86305

Status:
Inactive
Inactive reason:
Latest date to dissolve
Registration:
Jul 21, 2000
Inactive since:
Dec 31, 2020
State ID:
L-0957397-9
Members:
Brek Lamont Peterson (Member), 2245 Sandia Dr, Prescott, AZ 86301 (Physical),Shayne Glen Peterson (Member), 1568 Eagle Pt Rd, Prescott, AZ 86301 (Physical)

Medical Practice licenses in Arizona










Other Doctors licenses in Arizona