Individual
BRANDON ST PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3228 N CLARK ST, CHICAGO, IL 60657-1602
(773) 857-0689
Mailing address
3635 N WILTON AVE APT 2, CHICAGO, IL 60613-4575
(615) 478-4575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.026357
IL
2251S0007X
Sports Physical Therapist
070.026357
IL
2251X0800X
Orthopedic Physical Therapist
070.026357
IL
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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