Organization
PETERSON PT LLC
Active
Other names
Peterson Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BREK LAMONT PETERSON (OWNER/PHYSICAL THERAPIST)
(928) 771-2977
Entity
Organization
Contact information
Practice address
1320 W IRON SPRINGS RD, PRESCOTT, AZ 86305-1414
(928) 771-2977
(928) 771-2987
Mailing address
1320 W IRON SPRINGS RD, PRESCOTT, AZ 86305-1414
(928) 771-2977
(928) 771-2987
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
5079
AZ
2080S0010X
Pediatric Sports Medicine Physician
5810
AZ
2080S0010X
Pediatric Sports Medicine Physician
6499
AZ
Other
Enumeration date
08/03/2006
Last updated
05/20/2024
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