Individual
DR. JORDAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
S83W27690 BEAVER TRL, MUKWONAGO, WI 53149-9662
(815) 814-4841
Mailing address
S83W27690 BEAVER TRL, MUKWONAGO, WI 53149-9662
(815) 814-4841
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2110
WI
Other
Enumeration date
11/04/2021
Last updated
10/06/2025
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