Individual
MRS. JEANNIE C PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 S KENDRICK AVE, SUITE 104E, GILLETTE, WY 82716-3848
(307) 257-9990
(307) 222-0614
Mailing address
PO BOX 1642, EVANSTON, WY 82931-1642
(307) 789-0664
(307) 222-0614
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/23/2016
Last updated
03/13/2017
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