Individual
DR. JON DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
513
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
513
MN LICENSE
MN
Enumeration date
02/27/2006
Last updated
02/22/2024
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