Individual
TAYLOR J PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1005 BELLEFONTAINE AVE STE 225, LIMA, OH 45804-2896
(419) 998-8276
(419) 998-8277
Mailing address
1001 BELLEFONTAINE AVE, LIMA, OH 45804-2800
(419) 998-4575
(419) 998-4586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006906RX
OH
Other
Enumeration date
05/11/2020
Last updated
07/02/2021
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