Individual
TIFFANY LYNN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
116 N CIRCLE DR, ROCKY MOUNT, NC 27804-2401
(252) 451-0039
(866) 801-5246
Mailing address
116 N CIRCLE DR, ROCKY MOUNT, NC 27804-2401
(252) 451-0039
(866) 801-5246
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085GW
BCBS
NC
05
—
89085GW
—
NC
Enumeration date
11/06/2006
Last updated
07/08/2007
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