Individual
TRAVIS PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BOCP, COA
Contact information
Practice address
835 JOHNS HOPKINS DR, SUITE B, GREENVILLE, NC 27834-7268
(252) 752-7422
(252) 752-5424
Mailing address
835 JOHNS HOPKINS DR, SUITE B, GREENVILLE, NC 27834-7268
(252) 752-7422
(252) 752-5424
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
C52140
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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