Individual
JOHN T PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
(304) 329-1175
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
41232
WV
Other
Enumeration date
07/11/2006
Last updated
04/27/2017
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