Individual
DR. SHANE C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2303 SCHNEIDER AVE SE, SUITE 150, MENOMONIE, WI 54751-7005
(715) 233-1867
(715) 233-1868
Mailing address
2303 SCHNEIDER AVE SE, SUITE 150, MENOMONIE, WI 54751-7005
(715) 233-1867
(715) 233-1868
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3763
WI
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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