Individual
PEGGY JO WASSER SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01953
IA
226300000X
Kinesiotherapist
01953
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053755835
—
IA
Enumeration date
04/23/2013
Last updated
09/23/2013
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