Individual
MARY H PETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
2474 E JOYCE BLVD, STE, 2, FAYETTEVILLE, AR 72703-4519
(479) 521-8326
Mailing address
2474 E JOYCE BLVD, STE, 2, FAYETTEVILLE, AR 72703-4519
(479) 521-8326
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 1737
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 1737
STATE LICENSE
AR
Enumeration date
08/27/2008
Last updated
08/27/2008
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