Shane Peterson is a driver in Mora, MN. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. Shane Peterson NPI is 1972181246. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
325 WATKINS ST
MORA, MN
ZIP 55051-553
Phone: (320) 438-4493
The enumeration date for this NPI number is 3/30/2021 and was last updated on 3/30/2021.