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1114778438
COURTNEY ALYSSA PETERSON
PEORIA, IL
NPI
1114778438
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Former Name
COURTNEY HUMPAL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-27
Last Update Date
2024-03-27
Business Address
COURTNEY ALYSSA PETERSON DO
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2000
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Mailing Address
COURTNEY ALYSSA PETERSON DO
4101 W HOLLOW CREEK DR
PEORIA, IL 61615-5629
Phone number: 563-419-6885
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