Individual
REECE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
371 S WASHINGTON AVE, NEW RICHMOND, WI 54017-1511
(715) 220-3621
Mailing address
371 S WASHINGTON AVE, NEW RICHMOND, WI 54017-1511
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202059
MN
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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