Individual
KENNA RENEE PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5541 W 13400 S, RIVERTON, UT 84096-5640
(801) 871-4770
Mailing address
8195 S MAIO DR, SANDY, UT 84093-6773
(801) 703-1788
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12314965-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12314965-2401
UTAH DOPL PT LICENSE
UT
Enumeration date
10/13/2021
Last updated
12/20/2021
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