Individual
COREY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3186 AIRWAY AVE STE J, COSTA MESA, CA 92626-4650
(657) 418-6702
Mailing address
2345 NEWPORT BLVD APT L102, COSTA MESA, CA 92627-6533
(831) 566-9681
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC36259
CA
Other
Enumeration date
03/01/2022
Last updated
02/24/2024
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