Individual
CHAD JEREMY PETTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
825 BAHLS DRIVE, HASTINGS, MN 55033
(651) 480-1128
(651) 438-3929
Mailing address
825 BAHLS DRIVE, HASTINGS, MN 55033
(651) 480-1128
(651) 438-3929
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3748
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106179
HEALTH PARTNERS #
MN
01
—
198G8PE
BLUE CROSS BLUE SHIELD #
MN
01
—
CO3874
MEDICARE GROUP #
MN
Enumeration date
11/08/2006
Last updated
07/08/2007
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