Individual
DR. JESSICA LYNN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND, LAC
Contact information
Practice address
1139 JOLIET ST, DYER, IN 46311-1926
(219) 641-7359
Mailing address
10653 MILLARD DR, SAINT JOHN, IN 46373-9150
(708) 712-1097
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
84000210A
IN
175F00000X
Naturopath
099.0134092
VT
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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