Individual
PAUL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4314 45TH ST N, FARGO, ND 58102-6915
(701) 850-9229
Mailing address
4314 45TH ST N, FARGO, ND 58102-6915
(701) 850-9229
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468840
—
ND
Enumeration date
01/09/2020
Last updated
01/09/2020
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