Individual
MR. JEFFREY PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4718 23RD AVE STE 500, MISSOULA, MT 59803-1133
(406) 329-2596
Mailing address
4718 23RD AVE STE 500, MISSOULA, MT 59803-1133
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTP-PTA-LIC-2286
MT
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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