Individual
MRS. LEAH KATHERINE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5395
Mailing address
W188S7694 OAK GROVE DR, MUSKEGO, WI 53150-9208
(262) 971-0751
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4610-024
WI
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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