Individual
RYAN PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 E MAIN ST APT A, VEVAY, IN 47043-9574
(812) 571-4373
Mailing address
406 E MAIN ST APT A, VEVAY, IN 47043-9574
(812) 571-4373
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002217A
IN
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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