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Individual

DR. JAMES TYLER PETERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
657 W 200 N, CEDAR CITY, UT 84720-2408
(435) 592-4845
Mailing address
657 W 200 N, CEDAR CITY, UT 84720-2408
(435) 592-4845

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7779072-1202
UT
111N00000X
Chiropractor
CHIA-1429
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
U000073714
PTAN
UT
Enumeration date
10/15/2010
Last updated
03/20/2012
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