Individual
MEREDITH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3902 SANDALWOOD LN, SUITE 140, PUEBLO, CO 81005-7501
(719) 248-9797
Mailing address
3902 SANDALWOOD LN, SUITE 140, PUEBLO, CO 81005-7501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16360
CO
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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