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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699755546 NPPES
Iowa MEDICAID 0285478
Iowa Other 33194

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