Organization
PETERSON CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY RUSSELL PETERSON D.C., (OWNER)
(801) 972-1222
Entity
Organization
Contact information
Practice address
1878 W 3600 S, WEST VALLEY, UT 84119-3893
(801) 972-1222
(801) 972-2134
Mailing address
1878 W 3600 S, WEST VALLEY, UT 84119-3893
(801) 972-1222
(801) 972-2134
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1737001202
UT
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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