Provider Demographics
NPI:1871534495
Name:VAN TWUYVER, PETER JOSEPH (PT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:VAN TWUYVER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROOSEVELT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2200
Mailing Address - Country:US
Mailing Address - Phone:978-531-5008
Mailing Address - Fax:978-531-5508
Practice Address - Street 1:1 ROOSEVELT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2200
Practice Address - Country:US
Practice Address - Phone:978-531-5008
Practice Address - Fax:978-531-5508
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist