Jedidiah Allen Petersen, PA

NPI #1366870206 in Polson, Montana

Provider Information

NPI Number
1366870206
Entity Type
Individual
Name
Jedidiah Allen Petersen, PA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA
Enumeration Date
Oct 30, 2013
Last Updated
Dec 8, 2015

Practice Location

Address
6 13TH AVE E
City
Polson
State
Montana
ZIP Code
59860-5315
Phone
(406) 883-5680

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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