NPI 1710524970

Sean Wiberg Peterson, MSLATATC

Practitioner Athletic Trainer Superior, WI

Practice location

Address: 1810 Catlin Ave Room 1246, Superior, WI 54880
Phone: (715) 395-4641
Mailing address: 915 E 5th St APT 3, Duluth, MN 55805-3809

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2201-39 (WI)

Other Specialist/Technologist providers in Wisconsin →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 3203 (MN)

Registry record

NPI: 1710524970
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Dec 2019
Record last updated: 6 Dec 2019

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.