Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEREMIAH BRAD PETERSEN, PTA
ActiveJEREMIAH BRAD PETERSEN, PTA is a Specialist healthcare provider located in GREENDALE, Wisconsin. NPI 1760797203 is currently active in the NPPES registry. Verify at CMS.
Specialist · GREENDALE, WI
Registration Details
- NPI Number
- 1760797203
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 9, 2010 (16.050622871053 yrs)
- Last Updated
- Dec 27, 2012
- License
-
1475-19 (WI)
Practice Information
- Address
-
5900 MOCKINGBIRD LNGREENDALE, WI, 531291459Browse WI providers · Browse ZIP 53129
- Phone
- 4144231399
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in GREENDALE, WI
| Name | Credential | NPI |
|---|---|---|
| GAIL M REAM | — | 1104163906 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.