Doctor Name: | MATTHEW S. PETERSON |
NPI Number: | 1508039777 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 295378-1202 |
Business Practice Address: | 103 N. 1st Street Elma, WA - 985410656 |
Business Phone Number: | 3604825155 |
Business Fax Number: | 3604824155 |
Mailing Address: | Po Box 656, ELMA |
State: | WA |
Postal Code: | 985410656 |
Phone Number: | 3604825155 |
Fax Number: | 3604824155 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 06/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 295378-1202 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
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. |