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Individual

DR. NICHOLE YVETTE PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1080 W BOISE AVE, BOISE, ID 83706-3502
(208) 388-1895
Mailing address
2418 ELMCREST LN, BOISE, ID 83705-4327
(208) 794-1159

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHAI-1227
ID

Other

Enumeration date
02/15/2007
Last updated
07/08/2007
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