Individual
MR. PAUL ARTHUR PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
46400 ALGONKIAN PKWY, POTOMAC FALLS, VA 20165-6487
(703) 444-7542
(703) 444-7552
Mailing address
640 W COUNTRY CLUB DR, PURCELLVILLE, VA 20132-3042
(540) 751-1717
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000133
VA
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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