Individual
SARAH J PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
555 E BROADWAY AVE, STE 201, JACKSON, WY 83001-8640
(307) 739-7634
(307) 739-7632
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-7634
(307) 739-7632
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1016333
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143782800
—
WY
Enumeration date
10/09/2015
Last updated
02/17/2021
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