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Jeremiah Brad Petersen, PTA
Specialist in Greendale, Wisconsin
NPI 1760797203

Jeremiah Brad Petersen is a Specialist based in Milwaukee, WI. Jeremiah Brad Petersen practices in Greendale, WI and has the professional credentials of PTA. The NPI Number for Jeremiah Brad Petersen is 1760797203 and holds a License No. 1475-19 (Wisconsin).

The current practice location address for Jeremiah Brad Petersen is 5900 Mockingbird Ln, Greendale, WI and can be reached out via phone at 414-423-1399.

Location: 5900 Mockingbird Ln, Greendale, WI, 53204-1483
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760797203
Provider Name
Jeremiah Brad Petersen
Credential
PTA
Provider Entity Type
Individual
Gender
Male
Address
5900 Mockingbird Ln, Greendale, WI, 53204-1483
Phone Number
414-423-1399
Fax Number
Provider Enumeration Date
08/09/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5900 Mockingbird Ln
City
Greendale
State
Wisconsin
Zip
53129-1459
Phone Number
414-423-1399
Fax Number
person
Provider Business Mailing Address Details
Address
5900 Mockingbird Ln
City
Greendale
State
Wisconsin
Zip
53129-1459
Phone Number
414-423-1399
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1475-19 (Wisconsin)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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