Provider Demographics
NPI:1437877453
Name:PETERS, JAMIE L (DPT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:PETERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:L
Other - Last Name:FRYETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 15TH STREET PL
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-2411
Mailing Address - Country:US
Mailing Address - Phone:509-995-8558
Mailing Address - Fax:
Practice Address - Street 1:625 15TH STREET PL
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-2411
Practice Address - Country:US
Practice Address - Phone:509-995-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist