Individual
NORDELL E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1425 S 1500 E, CLEARFIELD, UT 84015-1621
(801) 779-0798
(801) 779-2798
Mailing address
1450 SOUTH 1500 EAST, CLEARFIELD, UT 84015-1633
(801) 397-4340
(801) 397-4390
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1101962401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
460488423001
—
UT
Enumeration date
07/19/2006
Last updated
07/09/2007
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