Peterson, Constance V

Peterson, Constance V is an individual health care provider with primary practice located at 187 Gallaher Rd , Kingston TN 37763-4721. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Peterson, Constance V can be contacted via phone (865) 376-4620.

Contact Information

Primary practice address
187 Gallaher Rd Kingston TN 37763-4721
Phone: (865) 376-4620
Fax: (865) 376-1759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 1095 Tennessee

Profile Details

NPI number 1851323067
LBN Legal business name Peterson, Constance V
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851323067 NPPES
Tennessee MEDICAID 5440745
Tennessee Other 4005129

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