Organization
SOUTHWEST CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD NIEL PETERSON D.C. (PRESIDENT)
(801) 254-9400
Entity
Organization
Contact information
Practice address
10358 S 1700 W, SOUTH JORDAN, UT 84095-9339
(801) 254-9400
(801) 254-5739
Mailing address
10358 S 1700 W, SOUTH JORDAN, UT 84095-9339
(801) 254-9400
(801) 254-5739
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870503754002
—
UT
Enumeration date
12/16/2010
Last updated
12/16/2010
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