Individual
JENNIFER KAY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11671 FOUNTAINS DR, SUITE 220, MAPLE GROVE, MN 55369-4711
(763) 420-2767
Mailing address
11671 FOUNTAINS DR, SUITE 220, MAPLE GROVE, MN 55369-4711
(763) 420-2767
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5150
MN
Other
Enumeration date
10/06/2006
Last updated
03/17/2015
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