| Doctor Name: | KIMBERLEE A PETERSON |
| NPI Number: | 1992807036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT1528 |
| Business Practice Address: | 172 W Main St Kuna, ID - 83634 |
| Business Phone Number: | 2089229828 |
| Business Fax Number: | 2089223499 |
| Mailing Address: | Po Box 711185, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 84171 |
| Phone Number: | 8019423311 |
| Fax Number: | 8019425955 |
| NPI Enumeration Date: | 09/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT1528 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |