Individual
TRACY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
500 HARVARD ST SE, MAYO 450/ MMC 106, MINNEAPOLIS, MN 55455-0363
(612) 273-8922
Mailing address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-8922
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2069
MN
Other
Enumeration date
07/12/2016
Last updated
08/22/2016
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