Individual
MR. BRAXTON EARL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, AS
Contact information
Practice address
107 N ELM ST, WILLIAMSTON, NC 27892-2301
(252) 802-1683
Mailing address
10220 HWY 125, OAK CITY, NC 27857-9998
(252) 802-1683
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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