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Organization

DR. TIM PETERSON, PLLC

Active
Other names
Peterson Chiropractic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY WARD PETERSON DC (OWNER)
(210) 691-2747
Entity
Organization

Contact information

Practice address
4230 GARDENDALE ST STE 201, SAN ANTONIO, TX 78229-3476
(210) 691-2747
(210) 691-2872
Mailing address
4230 GARDENDALE ST STE 201, SAN ANTONIO, TX 78229-3476
(210) 691-2747
(210) 691-2872

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7180
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548312382
INDIVIDUAL NPI
TX
Enumeration date
06/29/2018
Last updated
06/29/2018
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