Individual
COLLEEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
8015 LAWNDALE AVE, PHILADELPHIA, PA 19111-1507
(215) 725-2525
Mailing address
1218 MELODY LN, SOUTHAMPTON, PA 18966-4320
(215) 364-5102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003064E
PA
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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