Individual
NICHOLAS PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9550 HIGHWAY 412 W, LEXINGTON, TN 38351-5849
(731) 967-3224
(731) 967-3305
Mailing address
9550 HIGHWAY 412 W, LEXINGTON, TN 38351-5849
(731) 967-3224
(731) 967-3305
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4780
TN
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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