OrganizationActive
Peterson PT LLC
NPI 1669480968 · Pediatric Sports Medicine Physician · Prescott, AZ
Provider details
- NPI number
- 1669480968
- Entity type
- Organization
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Brek Peterson, Owner/Physical Therapist
- License
- 5810 (AZ)
Practice location
1320 W Iron Springs Rd
Prescott, AZ 86305-1414
Phone: (928) 771-2977
Fax: (928) 771-2987
Mailing address
1320 W Iron Springs Rd
Prescott, AZ 86305-1414
Registry dates
- Enumerated
- 2006-08-03
- Last updated
- 2024-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.