Individual
MARLISA S PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
325 W LIBERTY ST, SUMTER, SC 29150-5139
(803) 774-7000
(803) 774-7004
Mailing address
325 W LIBERTY ST, SUMTER, SC 29150-5139
(803) 774-7000
(803) 774-7004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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