National Provider Identifier

Todd Peterson, ATC, PTA

Todd Peterson, ATC, PTA is listed in the NPPES registry with a primary specialty of Athletic Trainer in Rochester, NY and a listed phone number of (585) 225-6296.

NPI 1790828531Rochester, NYAthletic Trainer

Profile Overview

NPI
1790828531
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
February 14, 2007
Last Updated
September 11, 2025

Practice Location

  • 120 Erie Canal Dr
  • Rochester, NY 14626-4607

Phone: (585) 225-6296

Mailing Address

  • P.O. Box 195
  • East Pembroke, NY 14056

Specialties

  • Athletic Trainer (2255A2300X)
  • Physical Therapy Assistant (225200000X)
Full Record
NPI
1790828531
Entity Type
Individual
Last Name
Peterson
First Name
Todd
Credential
ATC, PTA
Mailing Street Address
P.O. Box 195
Mailing City
East Pembroke
Mailing State
NY
Mailing ZIP Code
14056
Mailing Country
US
Mailing Phone
(585) 762-8883
Practice Street Address
120 Erie Canal Dr
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626-4607
Practice Country
US
Practice Phone
(585) 225-6296
Enumeration Date
February 14, 2007
Last Updated
September 11, 2025
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X), Physical Therapy Assistant (225200000X)