Individual
DANIEL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2182 ANTRIM DR, DAVISON, MI 48423-8438
(810) 813-9882
Mailing address
2182 ANTRIM DR, DAVISON, MI 48423-8438
(810) 813-9882
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704205653
MI
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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