Individual
ERICK ALLEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, CCSP
Contact information
Practice address
816 BROAD ST, DURHAM, NC 27705-4148
(919) 286-7202
(919) 287-2302
Mailing address
816 BROAD ST, DURHAM, NC 27705-4148
(919) 286-7202
(919) 287-2302
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2865
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085AH
BLUE CROSS PROVIDER ID
NC
05
—
89085AH
—
NC
Enumeration date
06/22/2006
Last updated
07/08/2007
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