SearchMichigan320900000X

Mark Peterson

NPI 1841474012 · on the registry since 2007 · sole proprietor

Practice

Address
3351 36th St
Grand Rapids, MI 49331
Phone
(616) 831-5659

Registry record

Primary taxonomy
320900000X
320900000X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2007-12-24

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 Michigan