Individual
PETER THOMAS SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
380 OAK GROVE PKWY, VADNAIS HEIGHTS, MN 55127-8508
(952) 767-4200
Mailing address
2731 91ST CRES N, BROOKLYN PARK, MN 55443-3831
(763) 381-7437
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107127
MN
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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