Individual
MR. TERRENCE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
6508 WALSH BLVD, #D, CHARLOTTE, NC 28226-8375
(704) 540-4203
Mailing address
6508 WALSH BLVD, #D, CHARLOTTE, NC 28226-8375
(704) 540-4203
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10618
NC
Other
Enumeration date
02/22/2011
Last updated
02/22/2011
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