Individual
MR. JUSTIN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
3575 GREEN HAVEN WAY, MAINEVILLE, OH 45039-9209
(740) 649-0606
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
53969
OH
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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