Individual
ALEXANDER LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D-PT
Contact information
Practice address
3263 EATON RD, GREEN BAY, WI 54311-6830
(920) 433-6700
(920) 433-6719
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
16024-24
WI
225100000X
Physical Therapist
Primary
16062-24
WI
Other
Enumeration date
07/11/2022
Last updated
09/26/2022
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