Individual
BRIANNA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GREENWOOD AVE, MONTCLAIR, NJ 07042-3649
(973) 813-1735
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02110100
NJ
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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