IndividualActive
Dale Petersen, CP
NPI 1184827693 · Prosthetist · Marianna, FL
Provider details
- NPI number
- 1184827693
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CP
- Sex
- Male
- Sole proprietor
- No
- License
- PRO66 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4299 3rd Ave
Marianna, FL 32446-2136
Phone: (850) 526-0063
Fax: (850) 526-1317
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 430
Marianna, FL 32447-0430
Registry dates
- Enumerated
- 2007-06-11
- Last updated
- 2008-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.