Individual
JONATHAN PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 GRANT BLVD W, WABASHA, MN 55981-1042
(651) 565-5908
(651) 565-5910
Mailing address
1200 GRANT BLVD W, WABASHA, MN 55981-1042
(651) 565-5908
(651) 565-5910
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
33320
MN
Other
Enumeration date
02/28/2006
Last updated
07/08/2007
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