Individual
ELIZABETH ANN PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 W 52ND PL, TULSA, OK 74107-8919
(918) 600-6825
Mailing address
3801 W 52ND PL, TULSA, OK 74107-8919
(918) 600-6825
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
164860
OK
Other
Enumeration date
06/08/2021
Last updated
06/08/2021
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