Individual
MRS. ALICE WASHINGTON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
148 SAULS ST, LAKE CITY, SC 29560-2631
(843) 374-4433
Mailing address
202 WILLIAMSBURG AVE, LAKE CITY, SC 29560-2736
(843) 598-2905
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8484
SC
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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