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Contact Information

PETERSON PT LLC
1320 W IRON SPRINGS RD
PRESCOTT, AZ86305-1414
 Phone: 928-771-2977
 Fax: 928-771-2987
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2080S0010X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PETERSON PT LLC · (Female)

NPI Number 1669480968
Status Active
Credentials
Entity Individual
Enumeration date 08/03/2006
Last updated 05/20/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 5079
  • AZ License # 5810
  • AZ License # 6499
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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