Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT014058L | PA |
NPI | 1386815686 |
---|---|
Provider Name | Christopher A. Peasley |
First Address | Cherry Hill, NJ 08003-1000 |
Second Address | Cherry Hill, NJ 08003-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 18/04/2013 |