Individual
MR. LANNY C. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 321-2700
(210) 617-5676
Mailing address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 321-2700
(210) 617-5676
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
09/25/2007
Last updated
06/02/2008
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