NPI 1245636810

Meredith Peterson

Practitioner Specialist Pueblo, CO

Practice location

Address: 3902 Sandalwood Ln Suite 140, Pueblo, CO 81005-7501
Phone: (719) 248-9797

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 16360 (CO)

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Registry record

NPI: 1245636810
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Nov 2014
Record last updated: 10 Nov 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.