Individual
DR. TINA ANNE-MARIE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5703 75TH ST, KENOSHA, WI 53142-3603
(262) 697-1363
(262) 697-1388
Mailing address
5703 75TH ST, KENOSHA, WI 53142-3603
(262) 697-1363
(262) 697-1388
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3711-012
WI
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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