Individual
TY PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4269 CREPE MYRTLE CT UNIT E, MURRELLS INLET, SC 29576-4316
(703) 399-6086
Mailing address
4269 CREPE MYRTLE CT UNIT E, MURRELLS INLET, SC 29576-4316
(703) 399-6086
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3232
SC
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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