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General NPI Number Information
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NPI Number | 1013833854
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Entity Type | Individual
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Provider Name | MICHELLE LYNN PETERSON DPT, PHD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 108 N MAIN ST STE 2N
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City | CAPE MAY COURT HOUSE
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State | NJ
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Zip | 08210-2190
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Country | US
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Telephone | 609-778-9450
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Fax |
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Provider Business Mailing Address
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Address Line | 136 NEWELL RD
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City | HEISLERVILLE
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State | NJ
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Zip | 08324-2004
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Country | US
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Telephone | 856-498-3314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01214900
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License Number State | NJ
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