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Individual

DR. PAUL LEROY PETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2378 S AVE, MADRID, IA 50156-7593
(515) 795-3655
(515) 795-3656
Mailing address
2378 S AVE, MADRID, IA 50156-7593
(515) 795-3655
(515) 795-3656

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A05497
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0431379
IA
01
18766
BLUE CROSS
05
2102442
IA
Enumeration date
10/17/2005
Last updated
10/18/2023
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