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Dale Edmund Petersen JR., CP
Prosthetist in Marianna, Florida
NPI 1184827693

Dale Edmund Petersen JR. is a Prosthetist based in Marianna, FL. Dale Edmund Petersen JR. practices in Marianna, FL and has the professional credentials of CP. The NPI Number for Dale Edmund Petersen JR. is 1184827693 and holds a License No. PRO66 (Florida).

The current practice location address for Dale Edmund Petersen JR. is 4299 3Rd Ave, Marianna, FL and can be reached out via phone at 850-526-0063 and via fax at 850-526-1317.

Location: 4299 3Rd Ave, Marianna, FL, 32447-0430
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1184827693
Provider Name
Dale Edmund Petersen JR.
Credential
CP
Provider Entity Type
Individual
Gender
Male
Address
4299 3Rd Ave, Marianna, FL, 32447-0430
Phone Number
850-526-0063
Fax Number
850-526-1317
Provider Enumeration Date
06/11/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4299 3Rd Ave
City
Marianna
State
Florida
Zip
32446-2136
Phone Number
850-526-0063
Fax Number
850-526-1317
person
Provider Business Mailing Address Details
Address
4299 3Rd Ave
City
Marianna
State
Florida
Zip
32446-2136
Phone Number
850-526-0063
Fax Number
850-526-1317
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Prosthetist
Speciality
-
Taxonomy
224P00000X
License No.
PRO66 (Florida)
Definition
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
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