Jeffrey Petersen, PT

NPI #1912367251 in Bonners Ferry, Idaho

Provider Information

NPI Number: 1912367251
Entity Type: Individual
Name: Jeffrey Petersen, PT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Feb 29, 2016
Last Updated: Feb 29, 2016

Practice Location

Address: 6640 KANIKSU ST
City: Bonners Ferry
State: Idaho
ZIP Code: 83805-7532
Phone: (208) 267-3141

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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