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Individual

MR. MICHAEL PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT, OTRL

Contact information

Practice address
75 N 200 W, VERNAL, UT 84078-2001
(435) 789-6757
(435) 789-7892
Mailing address
75 N 200 W, VERNAL, UT 84078-2001
(435) 789-6757
(435) 789-7892

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3337764201
UT

Other

Enumeration date
06/12/2007
Last updated
07/08/2007
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