MR. Theodore William Peterson, O.T.R.

NPI #1558434928 in Pocatello, Idaho

Provider Information

NPI Number
1558434928
Entity Type
Individual
Name
MR. Theodore William Peterson, O.T.R.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Occupational Therapist
Credential
O.T.R.
Enumeration Date
Nov 15, 2006
Last Updated
Aug 18, 2008

Practice Location

Address
IDAHO STATE UNIVERSITY
Address 2
CAMPUS BOX 8045
State
Idaho
ZIP Code
83209-0001
Phone
(208) 282-4631

Specialties & Taxonomy Codes

Specialty
Occupational Therapist

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