Individual
DR. TIMOTHY J PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
562 12TH ST W, DICKINSON, ND 58601-3509
(701) 483-1104
(701) 483-1443
Mailing address
562 W 12TH, DICKINSON, ND 58601-3509
(701) 483-1104
(701) 483-1443
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
564
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12125
BLUE CROSS BLUE SHIELD
ND
05
—
17920
—
ND
Enumeration date
08/29/2006
Last updated
12/01/2008
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