Individual
HALEY TANYA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
11995 SINGLETREE LN STE 120, EDEN PRAIRIE, MN 55344
(952) 373-5141
(763) 260-7653
Mailing address
11995 SINGLETREE LN STE 120, EDEN PRAIRIE, MN 55344-5338
(952) 373-5720
(763) 260-7653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11173
MN
225100000X
Physical Therapist
60885893
WA
Other
Enumeration date
09/28/2018
Last updated
09/18/2019
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