Individual
BLAKE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1878 W 3600 S, WEST VALLEY CITY, UT 84119-3893
(801) 972-1222
Mailing address
1878 W 3600 S, WEST VALLEY CITY, UT 84119-3893
(801) 972-1222
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10874281-1202
UT
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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