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1235980756
JACK MARTIN PETERSON
FORT SAM HOUSTON, TX
NPI
1235980756
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2024-04-01
Last Update Date
2024-04-01
Business Address
JACK MARTIN PETERSON MD
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234-4504
Phone number: 210-916-4141
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Mailing Address
JACK MARTIN PETERSON MD
2809 S 50TH ST
OMAHA, NE 68106-3130
Phone number: 507-226-5964
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