Mark Alan Peterson, EdS
In Home Supportive Care in Johnston, IA. Individual provider (NPI-1).
NPI number1164069696
StatusActive
Last updated in NPPESDec 3, 2019
Details
- NPI
- 1164069696
- Entity type
- Individual (NPI-1)
- Name
- Mark Alan Peterson
- Credential
- EdS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 3, 2019
- Last updated
- Dec 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | IA | Yes |
Practice location
5870 Nw 54th CtJohnston, IA 50131-1418
Phone 515-462-4367
Mailing address
5870 Nw 54th CtJohnston, IA 50131-1418
Phone 515-462-4367
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All 6 In Home Supportive Care Agency providers in Johnston · All 771 providers in Johnston
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