| Doctor Name: | MR. BEN PETERSON |
| NPI Number: | 1144207044 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT |
| License Number: | 11-03430 |
| Business Practice Address: | 4460 S Noland Rd Independence, MO - 640554743 |
| Business Phone Number: | 8163732845 |
| Business Fax Number: | 8163732842 |
| Mailing Address: | 5541 W 98th Pl, OVERLAND PARK |
| State: | KS |
| Postal Code: | 662072961 |
| Phone Number: | 9139404728 |
| Fax Number: | 8163732842 |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 11-03430 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| 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 |