Individual
MARK ALAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDS
Contact information
Practice address
5870 NW 54TH CT, JOHNSTON, IA 50131-1418
(515) 462-4367
Mailing address
5870 NW 54TH CT, JOHNSTON, IA 50131-1418
(515) 462-4367
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
IA
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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