Doctor Name: | EMILIE L PETERSON |
NPI Number: | 1588065882 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT-3602 |
Business Practice Address: | 1800 Flandro Dr Ste 190 Pocatello, ID - 832024940 |
Business Phone Number: | 2082332248 |
Business Fax Number: | |
Mailing Address: | 2001 Birdie Thompson Dr Apt 801, POCATELLO |
State: | ID |
Postal Code: | 832012774 |
Phone Number: | 2085703636 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2014 |
NPI Last Update Date: | 09/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-3602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |