Individual
THOMAS ADAM PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
8820 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 998-1551
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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