Individual
PETER MICHEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4545 GREYBERRY DR, CROWLEY, TX 76036-4229
(682) 701-7654
Mailing address
4545 GREYBERRY DR, CROWLEY, TX 76036-4229
(682) 701-7654
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
43222871
TX
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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