Individual
BLAKE HAMMOND PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5400 N OAK TRFY STE 103, KANSAS CITY, MO 64118-4689
(816) 455-0301
Mailing address
5400 N OAK TRFY STE 103, KANSAS CITY, MO 64118-4689
(816) 455-0301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2018022252
MO
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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