Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Broderick Earl Peariso, PTA

Individual provider Physical Therapy Assistant · NPI 1669727871

Broderick Earl Peariso, PTA is a Physical Therapy Assistant in Lansing, Michigan. Licensed in Michigan. Registered with an NPI since 2012.

Licensed in
MI
In the registry since
2012
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

3370 E Jolly Rd
Lansing, MI 48910-8552
Phone: (517) 332-7246
Fax: (517) 332-1474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502001428 (MI)

Record details

NPI number1669727871
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedJuly 14, 2012
Last updated in NPPESJuly 14, 2012

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