Doctor Name: | DR. CORY PETERSON |
NPI Number: | 1740689561 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T., D.P.T. |
License Number: | 1248191 |
Business Practice Address: | 1700 E Palm Valley Blvd Suite 395 Round Rock, TX - 786644677 |
Business Phone Number: | 5123544067 |
Business Fax Number: | 5123544068 |
Mailing Address: | 1700 E Palm Valley Blvd, Suite 395 ROUND ROCK |
State: | TX |
Postal Code: | 786644677 |
Phone Number: | 5123544067 |
Fax Number: | 5123544068 |
NPI Enumeration Date: | 08/18/2014 |
NPI Last Update Date: | 08/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1248191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |