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Individual

DR. MICHAELA A PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC, FACO

Contact information

Practice address
650 MAIN ST, BRANFORD, CT 06405-3613
(203) 481-6150
(203) 481-0411
Mailing address
36 WOODVALE RD, BRANFORD, CT 06405-3927
(203) 481-0510

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CT0469
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046900
CTCARE
CT
01
050000469CT01
BCBS
CT
01
350052269
RAILROAD MEDICARE
CT
01
CT00469
LANDMARK
CT
01
NHS019
OXFORD/TRIAD
CT
01
OV4757
HEALTHNET
CT
Enumeration date
01/25/2006
Last updated
01/07/2010
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