Individual
MR. BRIAN EUGENE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
12139 S. WILLIAMS ST, DUNELLON, FL 34431
(352) 489-2500
Mailing address
4980 SW 195TH AVE, DUNNELLON, FL 34431
(352) 465-7833
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 17956
FL
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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