Individual
LINEA CA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2205 28TH ST W APT 13, WILLISTON, ND 58801-2448
(701) 570-9594
Mailing address
514 10TH AVE W, WILLISTON, ND 58801-4837
(701) 609-0004
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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