Individual
DANIEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5800 BRODIE LN APT 216, AUSTIN, TX 78745-2530
(919) 454-1972
Mailing address
5800 BRODIE LN APT 216, AUSTIN, TX 78745-2530
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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