NPI 1083750996

Eliza S. Petersen, AUDCCCA

Practitioner Audiologist Driggs, ID

Practice location

Address: 2740 Shadowmoon Ln STE 417, Driggs, ID 83422-5083
Phone: (307) 745-5587
Fax: (877) 515-1633
Mailing address: 1388 Mount Moriah Rd, Livermore, CO 80536-9311

Registered specialties (2)

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence AUD-1142 (ID)

Other Audiologist providers in Idaho →

Audiologist

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence A-974 (WY)

Registry record

NPI: 1083750996
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Jan 2007
Record last updated: 19 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.