MEDICARE: SUZANNE PETERS PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1023830650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE PETERS PT, DPT

Provider Business Mailing Address
First Line	:	884 26TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-3616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6981
Country	:	US
Telephone Number	:	650-285-1360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	10/25/2024

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