Individual
JUSTIN DANIEL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9516 STATE AVE STE B, MARYSVILLE, WA 98270-2277
(360) 658-8857
(360) 659-8296
Mailing address
111 TUMWATER BLVD SE STE 113, TUMWATER, WA 98501-6422
(360) 528-3300
(360) 528-8162
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61183342
WA
Other
Enumeration date
02/07/2022
Last updated
03/21/2023
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