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Organization
PETERSON HEALTH CLINIC LLC
Active
Organization
PETERSON HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD G PETERSON JR. D.C. (OWNER/PHYSICIAN)
(618) 589-3911
Entity
Organization
Contact information
Practice address
815 LINCOLN HIGHWAY, SUITE 109, FAIRVIEW HEIGHTS, IL 62208
(618) 589-3911
(618) 589-3912
Mailing address
815 LINCOLN HIGHWAY, SUITE 109, FAIRVIEW HEIGHTS, IL 62208
(618) 589-3911
(618) 589-3912
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.012069
IL
111N00000X
Chiropractor
Primary
248.000537
IL
Other
Enumeration date
01/06/2012
Last updated
12/15/2015
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