Individual
DR. PETER ALBERT LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
19449 EVANS ST NW, SUITE A, ELK RIVER, MN 55330-1074
(612) 702-9012
(763) 633-0039
Mailing address
19449 EVANS ST NW, SUITE A, ELK RIVER, MN 55330-1074
(612) 702-9012
(763) 633-0039
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3805
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4487073
MEDICA GROUP ID
MN
01
—
45D48LA
BLUECROSS PIN
MN
01
—
94631
HEALTH PARTNERS GROUP NUM
MN
Enumeration date
05/03/2006
Last updated
07/30/2007
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