Individual
MOLLY JO PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2420 NW 115TH AVE, CORAL SPRINGS, FL 33065-3422
(954) 552-4351
Mailing address
2420 NW 115TH AVE, CORAL SPRINGS, FL 33065-3422
(954) 552-4351
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1659
FL
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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