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Individual

VICTOR M PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPT

Contact information

Practice address
1784 ELKAHATCHEE RD, ALEXANDER CITY, AL 35010-4800
(256) 234-0592
(256) 234-7014
Mailing address
1784 ELKAHATCHEE RD, ALEXANDER CITY, AL 35010-4800
(256) 234-0592
(256) 234-7014

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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