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1487333548
LORA JEAN PETERSON
JACKSONVILLE, FL
NPI
1487333548
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Former Name
LORA PETERSON GARRETT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA9114289)
Enumeration Date
2023-07-17
Last Update Date
2023-07-17
Business Address
Miss LORA JEAN PETERSON PA-C
1697 KINGS RD
JACKSONVILLE, FL 32209-6169
Phone number: 904-478-5483
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Mailing Address
Miss LORA JEAN PETERSON PA-C
15555 SPOTTED SADDLE CIR
JACKSONVILLE, FL 32218-7984
Phone number: 510-875-9909
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