Individual
NICHOLAS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
145 RAWLINGS RD, LIBBY, MT 59923-8918
(406) 334-3383
Mailing address
145 RAWLINGS RD, LIBBY, MT 59923-8918
(406) 334-3383
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-2446
MT
Other
Enumeration date
07/29/2021
Last updated
10/13/2021
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