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General NPI Number Information
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NPI Number | 1427336601
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Entity Type | Individual
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Provider Name | DAVID JAMES PETERSON DPT
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Gender | Male
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 28 MANO DR
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City | KULA
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State | HI
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Zip | 96790-8526
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Country | US
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Telephone | 808-446-0382
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Fax |
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Provider Business Mailing Address
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Address Line | 28 MANO DR
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City | KULA
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State | HI
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Zip | 96790-8526
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Country | US
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Telephone | 808-446-0382
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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 | 3396
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License Number State | HI
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