Individual
TERESA PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MS, PCS
Contact information
Practice address
6600 COLLEGE BLVD, SUITE 307, OVERLAND PARK, KS 66211-1939
(913) 345-1997
(913) 345-1990
Mailing address
6600 COLLEGE BLVD, SUITE 307, OVERLAND PARK, KS 66211-1939
(913) 345-1997
(913) 345-1990
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
11-00490
KS
2251P0200X
Pediatric Physical Therapist
2004034162
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100359840B
—
KS
05
—
485072409
—
MO
Enumeration date
01/26/2007
Last updated
05/15/2013
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