Individual
JACK DAVID PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 W STADIUM AVE, WEST LAFAYETTE, IN 47907-2046
(765) 496-0502
(765) 496-1239
Mailing address
800 W STADIUM AVE, WEST LAFAYETTE, IN 47907-2046
(765) 496-0502
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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