MEDICARE: CHERI L PETERSON PT, DPT, CSCS, CFC

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	5545	AZ
2	225100000X	Physical Therapist	9332	CO

General Provider Information

NPI Number	:	1124072954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERI L PETERSON PT, DPT, CSCS, CFC

Provider Business Mailing Address
First Line	:	COLORADO CENTER - TOWER 1
Second Line	:	2000 S. COLORADO BLVD, STE 1000
City	:	DENVER
State	:	CO
Zip	:	80222
Country	:	US
Telephone Number	:	720-848-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	COLORADO CENTER - TOWER 1
Second Line	:	2000 S. COLORADO BLVD, STE 1000
City	:	DENVER
State	:	CO
Zip	:	80222
Country	:	US
Telephone Number	:	720-848-2000
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	03/26/2020

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