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Organization

CHISHOLM TRAIL CLINIC OF CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD JAMES PETERSON D.C. (CHIROPRACTOR)
(512) 668-4163
Entity
Organization

Contact information

Practice address
731 S COLORADO ST, LOCKHART, TX 78644-3103
(512) 668-4163
Mailing address
1607 PAINTBRUSH DR, LOCKHART, TX 78644-3087
(512) 668-4163

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11510
TX

Other

Enumeration date
09/22/2010
Last updated
09/22/2010
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