Organization
TOOELE FAMILY CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW WADE PETERSON D.C. (PRESIDENT)
(435) 882-1621
Entity
Organization
Contact information
Practice address
134 W 1180 N, SUITE #5, TOOELE, UT 84074-1483
(435) 882-1621
Mailing address
134 W 1180 N, SUITE #5, TOOELE, UT 84074-1483
(435) 882-1621
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
370378-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87039551
—
UT
Enumeration date
01/31/2008
Last updated
07/09/2009
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