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Individual

SEAN WIBERG PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS LAT, ATC

Contact information

Practice address
1810 CATLIN AVE, ROOM 1246, SUPERIOR, WI 54880
(715) 395-4641
Mailing address
915 E 5TH ST APT 3, DULUTH, MN 55805-3809
(218) 590-5397

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2201-39
WI
2255A2300X
Athletic Trainer
3203
MN

Other

Enumeration date
12/06/2019
Last updated
12/06/2019
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