Individual
TAMARA SHEREE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
941 ARBOR WAY, MCDONOUGH, GA 30253-8710
(678) 661-1145
(562) 452-8328
Mailing address
941 ARBOR WAY, MCDONOUGH, GA 30253-8710
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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