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1174642136
JESSE PETERSON
CHICAGO, IL
NPI
1174642136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160003784)
Enumeration Date
2007-03-28
Last Update Date
2007-07-08
Business Address
Mr. JESSE PETERSON physical therapist
222 S RIVERSIDE PLZ STE 830
CHICAGO, IL 60606-5900
Phone number: 866-386-0773
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Mailing Address
Mr. JESSE PETERSON physical therapist
5015 N HERMITAGE AVE # 1
CHICAGO, IL 60640-2715
Phone number: 773-575-6563
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