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1326445198
MATHEW JAMES PETERSEN
SAINT LOUIS, MO
NPI
1326445198
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2012022607)
Enumeration Date
2014-11-21
Last Update Date
2014-11-21
Business Address
-- MATHEW JAMES PETERSEN ATC
10214 MUSICK RD
SAINT LOUIS, MO 63123-5066
Phone number: 314-882-7043
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Mailing Address
-- MATHEW JAMES PETERSEN ATC
10214 MUSICK RD
SAINT LOUIS, MO 63123-5066
Phone number: 314-882-7043
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