Individual
ETHAN E PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1311 WAKARUSA DR STE 1000, LAWRENCE, KS 66049-1741
(785) 749-1300
(785) 749-4746
Mailing address
1311 WAKARUSA DR STE 1000, LAWRENCE, KS 66049-1741
(785) 979-0690
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2024003248
MO
Other
Enumeration date
03/29/2024
Last updated
02/26/2025
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