Individual
DR. GREGORY JOSEPH PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9505 BLACKOAKS LN N, MAPLE GROVE, MN 55311-1229
(763) 420-4111
(763) 420-4145
Mailing address
9505 BLACKOAKS LN N, MAPLE GROVE, MN 55311-1229
(763) 420-4111
(763) 420-4145
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5767
MN
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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