Individual
VICTOR M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH2919
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#77553
UPIN
AL
01
—
515-28766
BCBS OF ALABAMA
AL
Enumeration date
06/27/2006
Last updated
08/30/2012
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