Individual
DAN JAMES PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
3032 HAMLIN DR, MACHESNEY PARK, IL 61115-7637
(815) 319-3333
Mailing address
3032 HAMLIN DR, MACHESNEY PARK, IL 61115-7637
(815) 319-3333
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005652
IL
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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