Individual
DR. CLAIRE NILES PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
612 N CHURCH ST, WATERTOWN, WI 53098-2111
(920) 261-1226
(920) 261-1435
Mailing address
N236 DANBURY DR, WATERTOWN, WI 53098-4565
(920) 261-1044
(920) 261-1435
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1330-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391281394018
B C
WI
Enumeration date
11/30/2006
Last updated
07/08/2007
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