TRAVIS DALE PETERSON

PROVO, UT
NPI1467195552
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LN0000X Nurse Practitioner, Neonatal
(Licence: UT  8058003-4405)
Enumeration Date2022-04-15
Last Update Date2023-01-09
Business Address
TRAVIS DALE PETERSON RN
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-7414
Mailing Address
TRAVIS DALE PETERSON RN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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