Individual
MR. TERRENCE WAYNE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2424 GRAY ST, EDGEWATER, CO 80214-1141
(303) 884-0565
(303) 884-0565
Mailing address
2424 GRAY ST, EDGEWATER, CO 80214-1141
(303) 884-0565
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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