Individual
PAMELA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2039 STURGEON ST, SPRINGFIELD, OH 45506-3429
(937) 561-4605
Mailing address
2039 STURGEON ST, SPRINGFIELD, OH 45506-3429
(937) 561-4605
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
371734660692
OH
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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