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Mathew Petersen, ATC
NPI 1326445198 · on the registry since 2014 · sole proprietor
Practice
- Address
- 10214 Musick Rd
Saint Louis, MO 63123 - Phone
- (314) 882-7043
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-11-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri