Dr. Gregory Joseph Petersen, D.C.
Chiropractor in Maple Grove, MN. Individual provider (NPI-1).
NPI number1851631907
StatusActive
Last updated in NPPESFeb 27, 2013
Details
- NPI
- 1851631907
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gregory Joseph Petersen
- Credential
- D.C.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 27, 2013
- Last updated
- Feb 27, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 5767 | MN | Yes |
Practice location
9505 Blackoaks Ln NMaple Grove, MN 55311-1229
Phone 763-420-4111 · Fax 763-420-4145
Mailing address
9505 Blackoaks Ln NMaple Grove, MN 55311-1229
Phone 763-420-4111 · Fax 763-420-4145
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