Individual
JORDAN B PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3835 SUPREME CT NW STE 2, BEMIDJI, MN 56601-4485
(218) 444-8280
(218) 444-8337
Mailing address
3835 SUPREME CT NW STE 2, BEMIDJI, MN 56601-4485
(218) 444-8280
(218) 444-8337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11996
MN
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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