Individual
THYRA PETERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 CENTENNIAL BLVD, FARGO, ND 58102
(218) 779-3188
Mailing address
1670 137TH AVE NE, HATTON, ND 58240-9014
(218) 779-3188
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/01/2025
Last updated
08/04/2025
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