Individual
KRISTEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1100 CIRCLE 75 PKWY SE STE 1400, ATLANTA, GA 30339-3067
(678) 403-3555
Mailing address
301 CALDWELL RD, BOWDON, GA 30108-2105
(770) 880-1929
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003395
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT003395
ATC LICENSE
GA
Enumeration date
01/13/2021
Last updated
01/13/2021
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