Petersen Chiropractic LLC

NPI #1023324597 in Gillette, Wyoming

Provider Information

NPI Number: 1023324597
Entity Type: Organization
Organization Name: Petersen Chiropractic LLC
Primary Specialty: Chiropractor
Enumeration Date: Aug 23, 2010
Last Updated: Aug 23, 2010

Practice Location

Address: 3805 S DOUGLAS HWY
Address 2: UNIT # 2
City: Gillette
State: Wyoming
ZIP Code: 82718-6554
Phone: (307) 686-0303

Authorized Official

Name: DR. CLINTON JEROME PETERSEN, D.C.
Title: DOCTOR/OWNER
Phone: (307) 686-0303

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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