| NPI | 1003931114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PATRICK PETERSON Owner 989-992-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501005682) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2012-10-19 |