Individual
JONATHON R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1585
ND
225100000X
Physical Therapist
7998
MN
Other
Enumeration date
08/17/2007
Last updated
07/21/2022
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