Individual
ANDREW PAUL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MAIL CODE 2433, MADISON, WI 53792-0001
(608) 662-0817
Mailing address
2615 MEADOWVIEW DR, JANESVILLE, WI 53546-4380
(608) 563-1530
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9826-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9826-24
PHYSICAL THERAPIST
WI
Enumeration date
12/10/2007
Last updated
01/06/2008
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