Doctor Name: | DR. MICHAELA A PETERSON |
NPI Number: | 1376513069 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DC, FACO |
License Number: | CT0469 |
Business Practice Address: | 650 Main St Branford, CT - 064053613 |
Business Phone Number: | 2034816150 |
Business Fax Number: | 2034810411 |
Mailing Address: | 36 Woodvale Rd, BRANFORD |
State: | CT |
Postal Code: | 064053927 |
Phone Number: | 2034810510 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2006 |
NPI Last Update Date: | 01/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CT0469 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |