Individual
TYLER PETERSON PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1334 N WHITMAN LN STE 100, LIBERTY LAKE, WA 99019-6034
(509) 924-1222
Mailing address
22809 E COUNTRY VISTA DR APT 124, LIBERTY LAKE, WA 99019-7546
(509) 953-6492
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
WA
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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