Shane Peterson is a Driver based in Mora, MN. Shane Peterson practices in Mora, MN. The NPI Number for Shane Peterson is 1972181246 and holds a License No. (Minnesota).
The current practice location address for Shane Peterson is 325 Watkins St, Mora, MN and can be reached out via phone at 320-438-4493.
Location: 325 Watkins St, Mora, MN, 55051-1553
Provider Profile Details
NPI Number
1972181246
Provider Name
Shane Peterson
Credential
Provider Entity Type
Individual
Gender
Male
Address
325 Watkins St, Mora, MN, 55051-1553
Phone Number
320-438-4493
Fax Number
Provider Enumeration Date
03/30/2021
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
325 Watkins St
City
State
Zip
55051-1553
Phone Number
320-438-4493
Fax Number
Provider Business Mailing Address Details
Address
325 Watkins St
City
State
Zip
55051-1553
Phone Number
320-438-4493
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
()
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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