Individual
DANIEL JOHN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, AT, ATC
Contact information
Practice address
320 S MAIN ST, OLIVET, MI 49076-9406
(269) 749-4169
Mailing address
320 S MAIN ST, OLIVET, MI 49076-9406
(269) 749-4169
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001177
MI
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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