Individual
JACOB CHRISTOPHER PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 W 14TH AVE STE 100, HOLDREGE, NE 68949-1215
(308) 995-4431
Mailing address
516 W 14TH AVE STE 100, HOLDREGE, NE 68949-1215
(308) 995-4431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29451
NE
Other
Enumeration date
06/11/2015
Last updated
01/25/2023
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