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CHARLES J PETERSON DC PC NPI 1083687636


NPI Information

NPI: 1083687636
Provider Name: CHARLES J PETERSON DC PC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1203 W SHERIDAN AVE
SHENANDOAH, IA
ZIP 51601
Phone: (712) 246-4798
Get Directions

CHARLES J PETERSON DC PC is a chiropractor in Shenandoah, IA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. CHARLES J PETERSON DC PC NPI is 1083687636. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1203 W SHERIDAN AVE
SHENANDOAH, IA
ZIP 51601
Phone: (712) 246-4798
Fax: (712) 246-5613

The provider's authorized official is Charles J Peterson .
The authorized official title is President and has the following contact phone number (712) 246-4798.

The enumeration date for this NPI number is 2/13/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor04065IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10015271MEDICAIDIOWA
201527OTHERIOWAWELLMARK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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