Individual
DR. KEVIN E. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
29 LAKE ST S, BIG LAKE, MN 55309-4588
(763) 263-3470
(763) 263-5900
Mailing address
29 LAKE ST S, BIG LAKE, MN 55309-4588
(763) 263-3470
(763) 263-5900
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
4263
MN
Other
Enumeration date
04/09/2007
Last updated
12/29/2010
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