Individual
KEVIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HHC, LMT
Contact information
Practice address
6989 UNIVERSITY AVE, WINDSOR HEIGHTS, IA 50324-1540
(515) 829-9477
Mailing address
170 EVERGREEN DR APT 200C, WAUKEE, IA 50263-8724
(515) 829-9477
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
225700000X
Massage Therapist
Primary
004782
IA
Other
Enumeration date
11/17/2015
Last updated
03/08/2022
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