Healthcare Provider Details

I. General information

NPI: 1871591859
Provider Name (Legal Business Name): PETERSON OXIMETRY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 ORCHARD DR
COLORADO SPRINGS CO
80920-7352
US

IV. Provider business mailing address

625 TRIUMPH DR
MIDDLETON ID
83644-6022
US

V. Phone/Fax

Practice location:
  • Phone: 208-461-2824
  • Fax:
Mailing address:
  • Phone: 208-461-2824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANET PETERSON
Title or Position: PRESIDENT
Credential: CRT
Phone: 208-461-2824