Individual
MARYPAT C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
113 CENTRAL AVE, COON VALLEY, WI 54623-8039
(608) 452-2525
(608) 452-2526
Mailing address
113 CENTRAL AVE, COON VALLEY, WI 54623-8039
(608) 452-2525
(608) 452-2526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3133-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38880300
—
WI
Enumeration date
08/31/2006
Last updated
04/12/2013
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