Organization
RETURN TO SPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB PETERSEN PT (PHYSICAL THERAPIST)
(515) 402-1522
Entity
Organization
Contact information
Practice address
8874 WOODMAYR CIR, NORWALK, IA 50211-1842
(515) 402-1522
Mailing address
PO BOX 363, NORWALK, IA 50211-0363
(515) 402-1522
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
091617
IA
Other
Enumeration date
06/23/2018
Last updated
06/23/2018
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