Individual
BRETT WILLIAM PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
—
—
225100000X
Physical Therapist
Primary
8649
MN
Other
Enumeration date
02/14/2012
Last updated
03/25/2016
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