Individual
DR. BRUCE ALLEN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2599 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5171
(651) 779-8115
(651) 779-9319
Mailing address
2599 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5171
(651) 779-8115
(651) 779-9319
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2446
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59434PE
BCBS
MN
Enumeration date
09/13/2006
Last updated
07/08/2007
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