Organization
PETERSEN TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B PETERSEN (MANAGER)
(309) 691-8113
Entity
Organization
Contact information
Practice address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
(309) 691-8113
Mailing address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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