Individual
LEEZA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 DEWEY ST, MANITOWOC, WI 54220-5497
(920) 686-5700
Mailing address
4100 DEWEY ST, MANITOWOC, WI 54220-5497
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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