Individual
DR. MCKAYLA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
701 W 6TH ST, GRAFTON, ND 58237-1379
(701) 871-8765
(701) 352-4410
Mailing address
701 W 6TH ST, GRAFTON, ND 58237-1379
(701) 352-4552
(701) 365-8134
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2110
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472555
—
ND
Enumeration date
05/11/2017
Last updated
08/27/2021
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