Individual provider · Type 1 NPI
Shane Peterson
Driver · Mora, MN
NPI number
1972181246
Active
Practice location
325 Watkins St
Mora, MN 55051-1553
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | None listed |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
About NPI 1972181246
Shane Peterson's National Provider Identifier is 1972181246, issued on Mar 30, 2021. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Mora, MN. The record was last updated on Mar 30, 2021.