Individual
ADAM GREGORY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
343 WOODLAKE DR SE, ROCHESTER, MN 55904-6242
(507) 281-6248
Mailing address
4573 RUBY LN NW, ROCHESTER, MN 55901-6562
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303436
MN
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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