Individual
LAUREN M PETOSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8600 N STATE ROUTE 91, PEORIA, IL 61615-9541
(309) 683-5050
(309) 683-5335
Mailing address
8600 N STATE ROUTE 91, PEORIA, IL 61615-9541
(309) 683-5050
(309) 683-5335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-005301
IL
Other
Enumeration date
10/08/2014
Last updated
03/14/2018
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