Organization
ORTONVILLE CHIROPRACTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY J PETERSON DC (CEO)
(320) 839-2323
Entity
Organization
Contact information
Practice address
215 2ND ST SE, ORTONVILLE, MN 56278-1537
(320) 839-2323
(320) 839-2324
Mailing address
215 2ND ST SE, ORTONVILLE, MN 56278-1537
(320) 839-2323
(320) 839-2324
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1992
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0468
HSM
MN
01
—
20341
SIOUX VALLEY HEALTH PLAN
SD
01
—
230670
ACN
MN
05
—
7602140
—
SD
Enumeration date
03/23/2007
Last updated
08/22/2020
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