Individual
TIMOTHY R PETERSON
Active
Individual
TIMOTHY R PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13659
CT
2251G0304X
Geriatric Physical Therapist
13659
CT
2251N0400X
Neurology Physical Therapist
13659
CT
2251S0007X
Sports Physical Therapist
13659
CT
2251X0800X
Orthopedic Physical Therapist
Primary
13659
CT
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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