Stephanie Ann Petersen, PTA

NPI #1578833711 in Kingsland, Georgia

Provider Information

NPI Number: 1578833711
Entity Type: Individual
Name: Stephanie Ann Petersen, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jan 5, 2012
Last Updated: Jan 5, 2012

Practice Location

Address: 100 LINDSEY LN # A
City: Kingsland
State: Georgia
ZIP Code: 31548-6850
Phone: (912) 729-1333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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