Individual
MRS. MARY KATHRYN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
4690 WHIPPLE RD, RIVERSIDE, CA 92506-1066
(951) 682-3341
Mailing address
4690 WHIPPLE RD, RIVERSIDE, CA 92506-1066
(951) 682-3341
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
23596
CA
2251P0200X
Pediatric Physical Therapist
23596
CA
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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