Individual
SHAWNA JONE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
18001 OLD CUTLER RD, SUITE 354, PALMETTO BAY, FL 33157-6422
(305) 251-7477
Mailing address
239 SW 30TH CT, MIAMI, FL 33135-2716
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 25162
FL
Other
Enumeration date
04/12/2010
Last updated
04/12/2010
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