Individual
DR. SHANNON PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
N275 MILITARY RD, SUITE 2, SHERWOOD, WI 54169-9603
(920) 989-1599
(920) 989-1593
Mailing address
N275 MILITARY RD, SUITE 2, SHERWOOD, WI 54169-9603
(920) 989-1599
(920) 989-1593
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3809-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38937000
—
WI
Enumeration date
06/28/2006
Last updated
07/08/2007
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