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Individual

DR. PETER G. BLUMENAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
320 EAST BROADWAY, SUITE 1C, JACKSON, WY 83001
(307) 734-0222
(307) 734-0222
Mailing address
PO BOX 12110, JACKSON, WY 83002-2110
(307) 734-0222
(307) 734-0222

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
605
WY

Other

Enumeration date
01/23/2008
Last updated
02/08/2010
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