Individual
MR. BRIAN CARL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
10439 64TH LN NE, ALBERTVILLE, MN 55301-3533
(763) 245-4115
Mailing address
10439 64TH LN NE, ALBERTVILLE, MN 55301-3533
(763) 245-4115
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A327
MN
Other
Enumeration date
06/05/2008
Last updated
06/05/2008
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