Individual
EMILY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
811 BROWN SCHOOL ROAD, EVANSVILLE, WI 53536
(608) 882-0302
Mailing address
P.O. BOX 3497, STURTEVANT, WI 53177-3497
(877) 552-2996
(866) 245-8064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36134700
—
WI
Enumeration date
03/05/2007
Last updated
07/08/2007
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