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1124216213
LACEY MARIE PETERSON
MADISON, WI
NPI
1124216213
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: SD 0174)
Enumeration Date
2007-10-15
Last Update Date
2007-10-15
Business Address
-- LACEY MARIE PETERSON CPTA
1807 PASO ROBLE WAY
MADISON, WI 53716-2418
Phone number: 605-267-0314
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Mailing Address
-- LACEY MARIE PETERSON CPTA
PO BOX 367 249 E 1ST ST
PARKER, SD 57053
Phone number: 605-297-2442
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