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WILEY PETERSEN, PA-C
PA-C
Physician Assistant
NPI: 1568920080IndividualAccepts Medicare
Specialties, Licenses & Credentials
Physician AssistantPrimary
Physician Assistant
Code: 363A00000X
PA-1714(ID)
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2018
Contact & Hours
- Address
- 134 W CHUBBUCK RD
CHUBBUCK, ID 83202 - Phone
- (208) 417-0102
Quick Facts
- NPI
- 1568920080
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 8
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