Individual
MICHELLE JO PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 9TH AVE S APT 4, GRAND FORKS, ND 58201-4202
(701) 740-5015
Mailing address
212 6TH ST NW, EAST GRAND FORKS, MN 56721-1823
(701) 740-5015
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/09/2024
Last updated
11/12/2024
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