Individual
AUSTIN MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
301 MN-65, MORA, MN 55051
(320) 679-2020
Mailing address
1893 PLUM ST, MORA, MN 55051-7220
(320) 282-0502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3870
MN
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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