Ian B Petersen, ATC-L
NPI #1255305850 in South Holland, Illinois
Provider Information
- NPI Number
- 1255305850
- Entity Type
- Individual
- Name
- Ian B Petersen, ATC-L
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC-L
- Enumeration Date
- Feb 13, 2006
- Last Updated
- Nov 26, 2007
Practice Location
- Address
- 345 TAFT ROAD
- City
- South Holland
- State
- Illinois
- ZIP Code
- 60473
- Phone
- (708) 596-0107
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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