Individual
MRS. SHERALEE DAHLE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
5169 S COTTONWOOD ST STE 520, MURRAY, UT 84107-6756
(801) 507-3500
(801) 507-3505
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3500
(801) 507-3505
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
5190165-4901
UT
363A00000X
Physician Assistant
Primary
5190165-1206
UT
363AM0700X
Medical Physician Assistant
5190165-1206
UT
Other
Enumeration date
08/24/2007
Last updated
06/23/2016
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