Individual
MICHEALA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 PRESIDENTS CIR, SALT LAKE CITY, UT 84112-9049
(801) 581-7200
Mailing address
201 PRESIDENTS CIR, SALT LAKE CITY, UT 84112-9049
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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