Individual
MATTHEW D PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6630 UNIVERSITY AVE, MIDDLETON, WI 53562-3036
(608) 263-8412
Mailing address
6630 UNIVERSITY AVE, MIDDLETON, WI 53562-3036
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2390-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2390-24
PT ORTHOPEDICS
WI
Enumeration date
07/24/2006
Last updated
03/22/2021
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