Individual
MICAH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 UNIVERSITY OF ARKANSAS, FAYETTEVILLE, AR 72701-1201
(479) 575-2000
Mailing address
1694 N WHISTLING STRAITS AVE APT 105, FAYETTEVILLE, AR 72704-6674
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/02/2025
Last updated
10/02/2025
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