Individual
JENNA M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
105170
IA
225100000X
Physical Therapist
Primary
12680
SC
225100000X
Physical Therapist
CP043561T
WI
Other
Enumeration date
09/14/2020
Last updated
04/12/2026
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