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General NPI Number Information
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NPI Number | 1447267984
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Entity Type | Individual
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Provider Name | LANCE R PETERSON PT
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 923 STATE ROUTE 46
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City | COLUMBIANA
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State | OH
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Zip | 44408
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Country | US
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Telephone | 330-482-6114
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Fax | 330-482-6115
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Provider Business Mailing Address
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Address Line | 100 ROYAL BIRKDALE DR
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City | COLUMBIANA
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State | OH
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Zip | 44408-8476
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Country | US
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Telephone | 330-482-3726
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Fax | 330-482-4505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT004652
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License Number State | OH
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