MRS. Jessica Petersen, PTA

NPI #1821393745 in Sandy, Utah

Provider Information

NPI Number: 1821393745
Entity Type: Individual
Name: MRS. Jessica Petersen, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jan 25, 2011
Last Updated: Jan 25, 2011

Practice Location

Address: 8550 S 300 E APT 3
City: Sandy
State: Utah
ZIP Code: 84070-1676
Phone: (307) 679-0532

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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