Organization
PETERSEN CHIROPRACTIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN S PETERSEN DC (DOCTOR)
(360) 275-8727
Entity
Organization
Contact information
Practice address
151 NE STATE ROUTE 300, BELFAIR, WA 98528-9615
(360) 275-8727
(360) 275-9695
Mailing address
PO BOX 370, BELFAIR, WA 98528-0370
(360) 275-8727
(360) 275-9695
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2694
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015212
—
WA
01
—
44709
LABOR AND INDUSTRIES
WA
Enumeration date
05/27/2009
Last updated
05/27/2009
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