Individual
TERRIE L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14631 W 79TH TER, LENEXA, KS 66215-4201
(913) 492-5293
Mailing address
14631 W 79TH TER, LENEXA, KS 66215-4201
(913) 492-5293
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/03/2008
Last updated
01/09/2008
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