Individual
MRS. BRIANA MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
574 E MIDDLE TPKE, MANCHESTER, CT 06040-3730
(860) 646-4334
(860) 646-7020
Mailing address
574 E MIDDLE TPKE, MANCHESTER, CT 06040-3730
(860) 646-4334
(860) 646-7020
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001595
CT
Other
Enumeration date
08/31/2006
Last updated
01/05/2010
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