Individual
DR. PETER JOSEPH ANTANAVICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1103 MAIN ST, LEICESTER, MA 01524-1393
(508) 892-8150
Mailing address
1103 MAIN ST, LEICESTER, MA 01524-1393
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2597
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y36790
CHIROPRACTIC
MA
Enumeration date
01/22/2007
Last updated
07/08/2007
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