J. Dayne Petersen M.d., PC
NPI #1346597507 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1346597507
- Entity Type
- Organization
- Organization Name
- J. Dayne Petersen M.d., PC
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Aug 7, 2012
- Last Updated
- Aug 30, 2012
Practice Location
- Address
- 5353 S 960 E
- Address 2
- #150
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84117-3569
- Phone
- (801) 261-5791
Authorized Official
- Name
- DR. JASON DAYNE PETERSEN, M.D.
- Title
- PRESIDENT
- Phone
- (801) 971-8684
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Medical Specialty — Medical Specialty |
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