Individual
JOSEPH JOHN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
106 NORTH 4TH AVENUE, FERGUS FALLS, MN 56537-1034
(218) 993-3778
(218) 993-3187
Mailing address
1525 4TH STREET N, FARGO, ND 58102
(701) 306-8603
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L064304-3
MN
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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