Individual
DR. MATTHEW WADE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10456 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 878-9565
(801) 432-8072
Mailing address
10456 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 878-9565
(801) 432-8072
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
370378-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870395551005
—
UT
Enumeration date
02/07/2006
Last updated
11/19/2012
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