Individual
MR. NOAH PAUL PETERSEN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
800 N 8TH ST, CLEAR LAKE, IA 50428-1539
(641) 456-6910
(641) 357-0021
Mailing address
800 N 8TH ST, CLEAR LAKE, IA 50428-1539
(641) 456-6910
(641) 357-0021
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
109205
IA
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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