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Individual

MR. MARK PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
800 S MOHAWK DR, SUITE D, ERWIN, TN 37650-2124
(423) 743-1245
(423) 743-2885
Mailing address
607 WALKERS BEND RD, GRAY, TN 37615-4165
(423) 743-1245
(423) 743-2885

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000005441
TN

Other

Enumeration date
04/26/2012
Last updated
04/26/2012
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