Individual
JEAN PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2 TITUS PLACE, WALTON, NY 13856
(607) 865-2400
(607) 865-7305
Mailing address
2 TITUS PLACE, WALTON, NY 13856
(607) 865-2400
(607) 865-7305
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9819
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30009798
—
NH
Enumeration date
07/06/2006
Last updated
10/06/2016
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