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1891123543
HENRY PETERSEN
COEUR D ALENE, ID
NPI
1891123543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-1146)
Enumeration Date
2013-10-16
Last Update Date
2017-01-24
Business Address
Mr. HENRY PETERSEN PA-C
700 W IRONWOOD DR STE 320
COEUR D ALENE, ID 83814-2656
Phone number: 208-625-5250
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Mailing Address
Mr. HENRY PETERSEN PA-C
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814-6051
Phone number: 208-625-5085
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