NPI 1023324597

Petersen Chiropractic LLC

Organisation Chiropractor Gillette, WY

Practice location

Address: 3805 S Douglas Hwy Unit # 2, Gillette, WY 82718-6554
Phone: (307) 686-0303
Fax: (307) 686-2882

Authorised official

Name: Clinton Jerome Petersen
Title: Doctor/Owner
Phone: (307) 686-0303

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 623 (WY)

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Registry record

NPI: 1023324597
Entity type: Organization
NPI issued: 23 Aug 2010
Record last updated: 23 Aug 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.