Glenn D Petersen PA-C

NPI 1013033323 - Preventive Medicine - 2083X0100X

NPI Details
NPI 1013033323
Gender Male
Enumeration Date 03/21/2007
Last Updated 06/12/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
1212 S BROADWAY
SUITE 150
DENVER CO, 80210-1582, US
Phone (615) 778-4066
Fax
Business Location
5080 SPECTRUM DR
SUITE 1200 WEST
ADDISON TX, 75001-4648, US
Phone (972) 364-8000
Fax (214) 775-4502
Toxanomy
Taxonomy Code 2083X0100X
License State Colorado
License Number 00239
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According to our database, Glenn D Petersen PA-C NPI is 1013033323, taxonomy code is 2083X0100X and license number is 00239, license state is located at Colorado. Glenn D Petersen PA-C physically located at 1212 S Broadway, Denver CO, 80210-1582. NPI Number Glenn D Petersen PA-C has the Individual type.

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1013033323 NPI number is provided on an as is basis without warranty of any kind. 1013033323 is maintained by the National Plan & Provider Enumeration System. The contents of Glenn D Petersen PA-C are for informational purposes only.