Individual
GEORGE JUSTIN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3064 FRIED AVE, SAN DIEGO, CA 92122-2235
(858) 405-2855
Mailing address
3064 FRIED AVE, SAN DIEGO, CA 92122-2235
(858) 405-2855
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
36323
CA
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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