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NPI Code Detail

MEDICARE: LINDSAY PETERSON MS, OTR/L

MEDICARE: LINDSAY PETERSON MS, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist104410MN

General Provider Information

NPI Number : 1902236532
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY PETERSON MS, OTR/L
Provider Business Mailing Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Provider Business Practice Location Address
First Line : 150 SAINT ANDREWS CT
Second Line : SUITE 310
City : MANKATO
State : MN
Zip : 56001-8659
Country : US
Telephone Number : 507-388-5437
Fax Number : 507-388-2108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2013
Last Update Date : 01/27/2021

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