Individual
MARA LYNN PETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
915 13TH AVE N, CLINTON, IA 52732-5067
(563) 243-2511
Mailing address
1216 N 49TH TER, SAINT JOSEPH, MO 64506-3260
(563) 249-2651
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
087985
IA
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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