Individual
MICHAIL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
2455 SW STATE ST, ANKENY, IA 50023-1277
(515) 963-4528
Mailing address
4516 EP TRUE PKWY APT 208, WEST DES MOINES, IA 50265-7615
(515) 360-2002
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
097021
IA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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