Peterson, Ricky L
Peterson, Ricky L is an sole proprietor health care provider with primary practice located at 1701 48Th Street Suite 120, West Des Moines IA 50266-6723. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Peterson, Ricky L can be contacted via phone (515) 224-1474.Contact Information
Primary practice address
1701 48Th Street Suite 120
West Des Moines IA 50266-6723
Phone: (515) 224-1474
Fax: (515) 224-1478
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 01473 | Iowa |
Profile Details
NPI number | 1699755546 |
---|---|
LBN Legal business name | Peterson, Ricky L |
Credentials | Physical Therapist (PT) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 18th, 2006 |
Last updated | Jun 4th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699755546 | NPPES |
Iowa | MEDICAID | 0285478 | |
Iowa | Other | 33194 |
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