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Individual

MARCO ANTONIO PETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2727 SOUTH BLVD, CHARLOTTE, NC 28209-1109
(704) 521-1389
(704) 527-3687
Mailing address
2727 SOUTH BLVD, CHARLOTTE, NC 28209-1109
(704) 521-1389
(704) 527-3687

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2998
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085G9
BCBS
NC
05
89085G9
NC
Enumeration date
07/21/2006
Last updated
11/13/2007
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