Peterson Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1194 Issued in CO

Legal business name

PETERSON CHIROPRACTIC CLINIC PC

Practice address

214 Colorado Ave
Pueblo, CO 81004

Phone

(719) 544-1085

Fax

(719) 544-1089

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Walter Oscar Peterson III, DC

Title

Pres

Phone

(719) 544-1085

Specialties & licenses 1

Addresses

Other names 1

• Peterson Chiropractic Clinic PC Other name

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740349059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81004",
            "telephone_number": "719-544-1085",
            "fax_number": "719-544-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81004",
            "telephone_number": "719-544-1085",
            "fax_number": "719-544-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "OSCAR",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "719-544-1085",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peterson Chiropractic Clinic PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leah M. Perry
• Troy Victor Perry, PHYSICAL THERAPIST A
• Michelle Perse, PT, DPT
• Kelli Sue Pershin, DDS
• Katrina Peter
• Alysia C Peterson, CCC-SLP
• Arlin Ray Peterson, DPM
• Bridget S Peterson, CRNFA
• Corigann Peterson
• Kelvin Lee Peterson, RPH

• Chiropractor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.