Individual
DR. CELESTE V PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
222 OAK ST, MOUNTAIN CITY, TN 37683-1526
(423) 727-6319
(423) 727-4164
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 727-6319
(423) 727-4164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
827
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3300550
—
TN
01
—
4085169
BCBST
TN
Enumeration date
06/14/2005
Last updated
01/29/2010
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