Peterson Chiropractic INC
Chiropractor in Lincoln, NE. Organization (NPI-2).
NPI number1114136140
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1114136140
- Entity type
- Organization (NPI-2)
- Legal business name
- Peterson Chiropractic INC
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 1372 | NE | Yes |
Other names
- Southpointe Chiropractic (Doing Business As)
Practice location
3200 Pine Lake RdSuite B
Lincoln, NE 68516-6035
Phone 402-423-5050 · Fax 402-423-5065
Mailing address
3200 Pine Lake RdSuite B
Lincoln, NE 68516-6035
Phone 402-423-5050 · Fax 402-423-5065
Authorized official
Jeremy Ryan Peterson
Owner
4024235050
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