Individual
MS. BOYD M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, SPINE CARE CLINIC AT PLANK ROAD, MILWAUKEE, WI 53226-3421
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2800
WI
111NS0005X
Sports Physician Chiropractor
2800
WI
111NX0800X
Orthopedic Chiropractor
Primary
2800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007000261F
HUMANA
—
05
—
1417901422
—
WI
Enumeration date
05/22/2006
Last updated
01/14/2026
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