Individual
GRETA PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6520
(231) 935-9116
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-6520
(231) 935-9116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003557
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP003557
BLUE CROSS
MI
Enumeration date
11/10/2006
Last updated
12/06/2011
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