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Individual

KENNETH R PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
62 FORT HILL RD STE B, GROTON, CT 06340-4398
(860) 440-6754
(860) 495-0043
Mailing address
62 FORT HILL RD, STE B, GROTON, CT 06340-4398
(860) 440-6754
(860) 440-6757

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001702
CT

Other

Enumeration date
04/13/2007
Last updated
06/24/2021
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