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Individual

DIANE K PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
208 MAIN ST, WAYNE, NE 68787-1941
(402) 833-5343
(402) 833-5349
Mailing address
208 MAIN ST, WAYNE, NE 68787-1941
(402) 833-5343
(402) 833-5349

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
687
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025617600
NE
Enumeration date
04/25/2008
Last updated
04/25/2008
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