NPI 1235259946

Jesse Peterson, LAC

Practitioner Acupuncturist Roseville, MN

Practice location

Address: 2151 Hamline Ave N STE 108, Roseville, MN 55113-4226
Phone: (612) 242-9630
Mailing address: 2151 Hamline Ave N Suite 108, Roseville, MN 55113-4236

Registered specialties

Acupuncturist Primary

Other Service Providers Taxonomy 171100000X Licence 1333 (MN)

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Registry record

NPI: 1235259946
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Mar 2007
Record last updated: 31 Mar 2011

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.