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NPI Code Detail

MEDICARE: REBECCA PETERSON PT, DPT

MEDICARE: REBECCA PETERSON 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
1225100000XPhysical Therapist6759NV

General Provider Information

NPI Number : 1578422457
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA PETERSON PT, DPT
Provider Business Mailing Address
First Line : 9550 W SAHARA AVE APT 1013
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5374
Country : US
Telephone Number : 651-274-8821
Fax Number :
Provider Business Practice Location Address
First Line : 3100 N TENAYA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0436
Country : US
Telephone Number : 651-274-8821
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2026
Last Update Date : 01/17/2026

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Directions to “ REBECCA PETERSON PT, DPT” Practice Location

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