Individual
DR. BRENT E. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1415 N 400 E, SUITE C, LOGAN, UT 84341-7539
(435) 787-1787
(435) 787-1797
Mailing address
1415 N 400 E, SUITE C, LOGAN, UT 84341-7539
(435) 787-1787
(435) 787-1797
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4827300-0151
UT
Other
Enumeration date
08/29/2007
Last updated
08/29/2007
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