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General NPI Number Information
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NPI Number | 1942843768
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Entity Type | Individual
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Provider Name | CLAIRE M PETERSON DPT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 8391 GREENWAY BLVD STE 130
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City | MIDDLETON
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State | WI
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Zip | 53562-3532
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Country | US
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Telephone | 608-790-9635
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Fax |
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Provider Business Mailing Address
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Address Line | 625 ENTERPRISE DR
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City | OAK BROOK
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State | IL
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Zip | 60523-8813
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Country | US
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Telephone | 630-576-6250
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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 |
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License Number State |
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