Organization
PAM PETERSEN HEARING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA R. PETERSEN MS, CCC-A (OWNER/AUDIOLOGIST)
(970) 527-6290
Entity
Organization
Contact information
Practice address
11931 4050 RD, PAONIA, CO 81428-6418
(970) 527-6290
(970) 527-3354
Mailing address
11931 4050 RD, PAONIA, CO 81428-6418
(970) 527-6290
(970) 527-3354
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
29
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07114556
—
CO
Enumeration date
02/09/2008
Last updated
02/11/2008
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