Individual
ANTHONY DAVID PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
619 6TH ST W, PARK RAPIDS, MN 56470-1301
(651) 528-2766
Mailing address
9203 RASPBERRY CT NE, BEMIDJI, MN 56601-7853
(651) 528-2766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11685
MN
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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