Individual
TRACY PETERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
833 GREENVILLE RD NE, BRISTOLVILLE, OH 44402-9767
(330) 980-3501
Mailing address
833 GREENVILLE RD NE, BRISTOLVILLE, OH 44402-9767
(330) 980-3501
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/08/2014
Last updated
09/23/2014
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