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Individual

TODD H PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
584 COUNTY LINE RD W, WESTERVILLE, OH 43082-7245
(614) 855-6011
Mailing address
584 COUNTY LINE RD W, WESTERVILLE, OH 43082-7245
(614) 855-6011

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-002338
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
NATIONWIDE CHILDRENS HOSPITAL
Enumeration date
02/11/2014
Last updated
02/11/2014
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