Individual
MRS. SUE MARIE PETERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LAT
Contact information
Practice address
1507 N 1ST ST, INDIANOLA, IA 50125
(515) 961-7435
(515) 961-7436
Mailing address
PO BOX 461, NEVADA, IA 50201-0461
(515) 382-3366
(515) 382-1576
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
123BB9961
IA
Other
Enumeration date
05/24/2006
Last updated
07/08/2007
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