Individual
PASSION PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
432 MEADOWLAKE DR, COLUMBIA, SC 29203-2418
(843) 630-4855
(843) 662-6697
Mailing address
432 MEADOWLAKE DR, COLUMBIA, SC 29203-2418
(843) 630-4855
(843) 662-6697
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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