Individual
RODNEY W PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF CHIROPRACT
Contact information
Practice address
2800 S UNIVERSITY DR, FARGO, ND 58103-6030
(701) 237-0614
(701) 237-0615
Mailing address
2800 S UNIVERSITY DR, FARGO, ND 58103-6030
(701) 237-0614
(701) 237-0615
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
515
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016742
—
ND
05
—
502228200
—
MN
Enumeration date
10/25/2006
Last updated
04/28/2008
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