Individual
DANA RICHARD PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
5915 S REGAL ST STE B218, SPOKANE, WA 99223-6970
(509) 499-1652
Mailing address
2622 E 61ST AVE, SPOKANE, WA 99223-6912
(509) 448-3977
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00024873
WA
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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