Individual
TYLER PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
205 EAST AVE, ONEIDA, NY 13421-2156
(315) 939-0317
Mailing address
117 ANTHONY LN, CLINTON, NY 13323-1064
(315) 939-0317
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
048232
NY
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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