Individual
PAMELA R PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
11931 4050 RD, PAONIA, CO 81428-6418
(970) 527-6290
(970) 527-3354
Mailing address
11931 4050 RD, PAONIA, CO 81428-6418
(970) 527-6290
(970) 527-3354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29
CO
Other
Enumeration date
12/05/2006
Last updated
10/30/2013
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