Individual
DAVONTE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2075 JORDAN AVE, JUNEAU, AK 99801-8095
(907) 854-7610
Mailing address
2075 JORDAN AVE, JUNEAU, AK 99801-8095
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/31/2021
Last updated
05/31/2022
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