Individual
MR. RICHARD L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2185 LIBERTY ST NE, SALEM, OR 97301-8353
(503) 371-4055
(503) 371-4885
Mailing address
2185 LIBERTY ST NE, SALEM, OR 97301-8353
(503) 371-4055
(503) 371-4885
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 1346
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R0000QGBLR
PTAN
OR
Enumeration date
07/12/2006
Last updated
10/18/2011
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