Individual
PEGGY VOLLSTAD
Active
Individual
PEGGY VOLLSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110004675
VA
363AS0400X
Surgical Physician Assistant
PA031065
DC
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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