Doctor Name: | GREG EDWARD PETERSEN |
NPI Number: | 1013013176 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | PT 20757 |
Business Practice Address: | 3878 W Carson St Suite 100 Torrance, CA - 905036707 |
Business Phone Number: | 3105434655 |
Business Fax Number: | 3105431743 |
Mailing Address: | 3878 W Carson St, Suite 100 TORRANCE |
State: | CA |
Postal Code: | 905036707 |
Phone Number: | 3105434655 |
Fax Number: | 3105431743 |
NPI Enumeration Date: | 09/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 20757 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |