Individual
MR. JAMES TIMOTHY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LCGC
Contact information
Practice address
3615 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4318
(267) 426-4961
Mailing address
MITOCHONDRIAL MEDICINE FRONTIER PROGRAM- 10TH FLOOR ARC, 3615 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
000488
PA
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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