Individual
JESSICA MARIE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 FOOTHILL DR, DEPT OF HOLISTIC MEDICINE, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
500 FOOTHILL DR, DEPT OF HOLISTIC MEDICINE, SALT LAKE CITY, UT 84148-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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