Individual
DR. JOEL DENNIS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3042 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2614
(612) 822-1090
Mailing address
3042 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2614
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3649
MN
Other
Enumeration date
07/23/2019
Last updated
08/08/2019
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