Individual
MR. COLE WILLIAM PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1900 SNELLING AVE N, FALCON HEIGHTS, MN 55113-5730
(612) 581-3250
Mailing address
1900 SNELLING AVE N, FALCON HEIGHTS, MN 55113-5730
(612) 581-3250
(612) 626-4789
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2105
MN
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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