Individual
SHANNON LYLE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
1870 PISGAH DR, HENDERSONVILLE, NC 28791-3759
(828) 693-9796
(828) 693-1321
Mailing address
212 S HILLANDALE DR, EAST FLAT ROCK, NC 28726-2610
(828) 696-5949
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8145
NC
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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