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1407063555
SHAWN LARAE PETERSON
JOPLIN, MO
NPI
1407063555
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MO 116146)
Enumeration Date
2007-05-17
Last Update Date
2007-07-08
Business Address
Mrs. SHAWN LARAE PETERSON PTA
4500 E 32ND ST
JOPLIN, MO 64804
Phone number: 417-623-6287
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Mailing Address
Mrs. SHAWN LARAE PETERSON PTA
4500 E 32ND ST
JOPLIN, MO 64804
Phone number: 417-623-6287
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