Individual
MISS SALLY GLADYS PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2515 UNIVERSITY AVE SE APT 101W, MINNEAPOLIS, MN 55414-3257
(507) 481-4649
Mailing address
2515 UNIVERSITY AVE SE APT 101W, MINNEAPOLIS, MN 55414-3257
(507) 481-4649
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/19/2022
Last updated
06/19/2022
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