Individual
GREG ROBERT PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2723 E 29TH CT, DAVENPORT, IA 52803-2112
(563) 370-7061
(563) 421-6099
Mailing address
2723 E 29TH CT, DAVENPORT, IA 52803-2112
(563) 370-7061
(563) 421-6099
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
580AH7464
IA
Other
Enumeration date
08/22/2017
Last updated
07/21/2022
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