Individual
BRENT LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
115 N COLLEGIATE DR, PARIS, TX 75460-4842
(903) 739-9948
(903) 739-9395
Mailing address
115 N COLLEGIATE DR, PARIS, TX 75460-4842
(903) 739-9948
(903) 739-9395
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
9087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
752961955
TAX ID
TX
Enumeration date
07/24/2006
Last updated
12/19/2007
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