Individual
SAMUEL BRANDT PETERSON
Active
Individual
SAMUEL BRANDT PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT, MOT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
16730
CA
225X00000X
Occupational Therapist
Primary
2021023073
MO
225X00000X
Occupational Therapist
363945
—
Other
Enumeration date
09/09/2016
Last updated
06/18/2021
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