Individual
EMILY MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
28975 OLD TOWN FRONT ST STE 201, TEMECULA, CA 92590-2863
(951) 595-1738
Mailing address
29842 LONGHORN DR, CANYON LAKE, CA 92587-7642
(714) 603-2037
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA48577
CA
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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