Organization
PETERSEN CHIROPRATIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE PAUL PETERSEN D.C. (PRESIDENT)
(303) 722-2273
Entity
Organization
Contact information
Practice address
1923 E KENTUCKY AVE, DENVER, CO 80209-4554
(303) 722-2273
(303) 282-7597
Mailing address
1923 E KENTUCKY AVE, DENVER, CO 80209-4554
(303) 722-2273
(303) 282-7597
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1833
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25521
TIN
CO
01
—
307178
PTAN
CO
Enumeration date
09/10/2013
Last updated
06/20/2018
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