Individual
MRS. JESSICA PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8550 S 300 E APT 3, SANDY, UT 84070-1676
(307) 679-0532
Mailing address
8550 S 300 E APT 3, SANDY, UT 84070-1676
(307) 679-0532
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7852051-2402
UT
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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