NPI 1124859525

Ayla Peterson

Practitioner Driver Two Harbors, MN

Practice location

Address: 1313 Fairgrounds Rd, Two Harbors, MN 55616-4600
Phone: (218) 969-6183

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence N000-024-230-200 (MN)

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Registry record

NPI: 1124859525
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Aug 2024
Record last updated: 8 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.