Individual
BETHANY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
701 E 63RD ST STE G10, KANSAS CITY, MO 64110-3305
(913) 575-8529
Mailing address
9616 LOWELL AVE, OVERLAND PARK, KS 66212-3304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-05180
KS
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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