Individual
GLENN D PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1212 S BROADWAY, SUITE 150, DENVER, CO 80210-1582
(615) 778-4066
Mailing address
5080 SPECTRUM DR, SUITE 1200 WEST, ADDISON, TX 75001-4648
(972) 364-8000
(214) 775-4502
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
00239
CO
Other
Enumeration date
03/21/2007
Last updated
06/12/2009
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