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

Mr. Kenneth Ryan Petersen, DPT, CSCS

Individual provider Physical Therapist · NPI 1578129763

Mr. Kenneth Ryan Petersen, DPT, CSCS is a Physical Therapist in Twin Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

754 N College Rd Ste D
Twin Falls, ID 83301-5822
Phone: (208) 734-5313
Fax: (208) 736-1582
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT6392 (ID)

Record details

NPI number1578129763
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT , CSCS
Sole proprietorNo
NPI enumeratedMay 14, 2019
Last updated in NPPESMay 14, 2019

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