Individual
MR. SCOTT MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
LEMOYNE COLLEGE SPORTS MEDICINE, 1419 SALT SPRINGS ROAD, SYRACUSE, NY 13214-1399
(315) 445-4417
(315) 445-6048
Mailing address
LEMOYNE COLLEGE SPORTS MEDICINE, 1419 SALT SPRINGS ROAD, SYRACUSE, NY 13214-1399
(315) 445-4417
(315) 445-6048
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000727-1
NY
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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