Doc'S Body Shop, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DOC'S BODY SHOP, PLLC

Doing business as

Office of Dr. Reese R. Petersen, DC

Practice address

2418 S 18TH St
Clinton, IA 52732-6827

Phone

(563) 259-6173

NPI assigned

Feb 18, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Reese Raymond Petersen, DCNPI 1942619713

Title

Sole Member/Owner

Phone

(563) 259-6173

Specialties & licenses 1

Addresses

Other names 1

• Office of Dr. Reese R. Petersen, DC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reese Raymond Petersen, DC

  • Chiropractor
  • Clinton, IA
  • NPI 1942619713
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1710510896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 S 18TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326827",
            "telephone_number": "563-259-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 S 18TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326827",
            "telephone_number": "563-259-6173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2319 S 19th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527326835",
            "country_code": "US",
            "telephone_number": "563-259-6173",
            "fax_number": "563-326-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DOC'S BODY SHOP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "REESE",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "SOLE MEMBER/OWNER",
        "authorized_official_telephone_number": "563-259-6173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Office of Dr. Reese R. Petersen, DC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kent Dexter
• Jenna M Dias, LMSW
• Todd Orin Dierks
• Taylor Diesch
• Joseph Dimino, D.C.
• Robert J Donnelly, M.D.
• Brian R Dornbush, D.C.
• Derald Dean Dosland, DDS
• Dr. Reese, Inc. (Pinnacle Sport & Spine Clinic)
• Laura Sue Dreckmeier, MPT

• Chiropractor in Clinton, IA
• Providers in Clinton, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.