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1790354264
ANDREW PETERSON
MERIDIAN, ID
NPI
1790354264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-7222)
Enumeration Date
2021-06-21
Last Update Date
2021-06-21
Business Address
ANDREW PETERSON DPT
3025 W CHERRY LN STE D
MERIDIAN, ID 83642-8531
Phone number: 208-367-8593
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Mailing Address
ANDREW PETERSON DPT
121 E VICTORY RD APT A202
MERIDIAN, ID 83642-6915
Phone number: 208-731-5267
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