DALE EDMUND PETERSEN JR. CP
NPI 1184827693
Prosthetist in Marianna, FL

Q: What is Dale Petersen's NPI number?

The NPI number for Dale Petersen is 1184827693. It was assigned to this individual provider in the NPPES registry on June 11, 2007.

Q: What is Dale Petersen's specialty?

The primary specialty registered for this NPI is Prosthetist with taxonomy code 224P00000X.

Q: When was this NPI record last updated?

The NPPES record for Dale Petersen was last updated on March 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 11, 2007

4299 3RD AVE, MARIANNA, FL 32446(850) 526-0063(850) 526-1317 Get Directions Write a Review

NPPES record last updated: March 28, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dale Edmund Petersen Jr. Cp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALE EDMUND PETERSEN JR. CP (NPI 1184827693) is an individual prosthetist provider in Marianna, Florida, licensed in Florida (PRO66) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1184827693

Entity TypeIndividualMale

Primary Taxonomy224P00000X

Provider Legal NameDALE EDMUND PETERSEN JR.Credential: CP

Location Address4299 3RD AVEMarianna, FL 32446-2136

Mailing AddressPo Box 430Marianna, FL 32447-0430 · (850) 526-0063

Phone(850) 526-0063

Fax(850) 526-1317

Sole ProprietorNo

Enumeration DateJune 11, 2007

Last NPPES UpdateMarch 28, 2008

✔ NPI 1184827693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code224P00000X

License✔ Licensed in FL · PRO66

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.

4299 3RD AVE, Marianna, FL 32446

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VITAL PROSTHETICS, INC.

Prosthetic/Orthotic Supplier

4299 3RD AVE
MARIANNA, FL 32446

Jackson County (850) 526-0063

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dale Petersen's NPI number?

The NPI number for Dale Petersen is 1184827693. It was assigned to this individual provider in the NPPES registry on June 11, 2007.

Where is Dale Petersen located?

Dale Petersen practices at 4299 3rd Ave, Marianna, FL 32446. The listed phone number is (850) 526-0063.

What is Dale Petersen's specialty?

The primary specialty registered for this NPI is Prosthetist with taxonomy code 224P00000X.

When was this NPI record last updated?

The NPPES record for Dale Petersen was last updated on March 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.