Individual
KATELYN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
2219 GARFIELD ST, TWO RIVERS, WI 54241-2416
(920) 793-2281
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13111-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100045290
—
WI
Enumeration date
05/27/2015
Last updated
06/17/2024
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