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Individual
SANDRA PETERSON
Active
Individual
SANDRA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LMT
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
MA46414
FL
163WM1400X
Nurse Massage Therapist (NMT)
RN9168919
FL
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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