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Individual

BRETT A PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
568 N SUNRISE AVE, #100, ROSEVILLE, CA 95661-3097
(916) 865-1100
(916) 865-1105
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23803
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PT0238030
CA
Enumeration date
09/15/2006
Last updated
07/29/2015
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