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Organization

CHRISTOPHER PETERSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER TYRONE PETERSON (STNA)
(216) 640-1898
Entity
Organization

Contact information

Practice address
10618 WOODLAND AVE APT A, CLEVELAND, OH 44104-2436
(216) 640-1898
Mailing address
10618 WOODLAND AVE, CLEVELAND, OH 44104-2436
(216) 640-1898

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
400516640605
OH

Other

Enumeration date
11/18/2013
Last updated
11/18/2013
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