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

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: July 26, 2026.

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
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

Other Providers at the Same Location NPPES

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

Prosthetic/Orthotic Supplier
4299 3RD AVE
MARIANNA, FL 32446

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 with the weekly NPPES data releases published by CMS.