Individual
JASON R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R D
Contact information
Practice address
1111 6TH AVE, SUITE 510, DES MOINES, IA 50314-2610
(515) 643-5275
(515) 643-5276
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
01563
IA
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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