Individual
MS. JESSACA LAUREN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARDMS
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
2678 HAMPTON PARK CIR, FOLEY, AL 36535-1130
(251) 752-0301
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
122613
AL
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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