Individual
HOWARD GALE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
807 E JACKSON BLVD, SUITE TWO, JONESBOROUGH, TN 37659-1507
(423) 753-4964
(423) 753-4121
Mailing address
807 E JACKSON BLVD, SUITE TWO, JONESBOROUGH, TN 37659-1507
(423) 753-4964
(423) 753-4121
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1759
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3971212
—
TN
01
—
4100327
BCBS
TN
Enumeration date
09/22/2006
Last updated
07/08/2007
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