Individual
CARL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3720 36TH AVE N, ST PETERSBURG, FL 33713-1304
(727) 521-2458
Mailing address
3720 36TH AVE N, ST PETERSBURG, FL 33713-1304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA7260
FL
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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