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

Dale Edmund Petersen Jr., CP

Individual provider Prosthetist · NPI 1184827693

Dale Edmund Petersen Jr., CP is a Prosthetist in Marianna, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007

Practice location Address checks out

4299 3rd Ave
Marianna, FL 32446-2136
Phone: (850) 526-0063
Fax: (850) 526-1317
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetist (primary) Taxonomy 224P00000X · Licence PRO66 (FL)

Record details

NPI number1184827693
Entity typeIndividual (Type 1)
GenderMale
Credentials CP
Sole proprietorNo
NPI enumeratedJune 11, 2007
Last updated in NPPESMarch 28, 2008