Individual
MR. JAMIE DUANE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
927 S CARMEL ST, CADILLAC, MI 49601-2547
(231) 876-3876
(231) 775-1115
Mailing address
3799 MOMENTUM PL, CHICAGO, IL 60689-5337
(231) 877-3876
(231) 775-1115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006140
MI
Other
Enumeration date
10/02/2006
Last updated
12/28/2020
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