Provider Demographics
NPI:1306874821
Name:PETERSON, ARTHUR (PT, PHD, DPT, CGS)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:PETERSON
Suffix:
Gender:M
Credentials:PT, PHD, DPT, CGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-4324
Mailing Address - Country:US
Mailing Address - Phone:561-697-8800
Mailing Address - Fax:561-697-3372
Practice Address - Street 1:5912 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4324
Practice Address - Country:US
Practice Address - Phone:561-697-8800
Practice Address - Fax:561-697-3372
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1469OtherMEDICARE GROUP NUMBER
FLY4308ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FLS70578Medicare UPIN