PETERSON CHIROPRACTIC CLINIC PC (NPI# 1740349059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740349059 |
| Entity Type | Organization |
| Organization Name | PETERSON CHIROPRACTIC CLINIC PC |
| Other Organization Name | PETERSON CHIROPRACTIC CLINIC PC |
| Practice Address |
214 Colorado Ave Pueblo CO 81004 |
| Practice Telephone | 7195441085 |
| Practice Fax Number | 7195441089 |
| Mailing Telephone | 7195441085 |
| Mailing Fax Number | 7195441089 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WALTER OSCAR PETERSON III (PRES) |
| Authorized Official Telephone | 7195441085 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1194 | CO | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Peterson Chiropractic Clinic PC | Other Name - Individual/Organization |
| Street Address |
214 COLORADO AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891154787 | Hill Chiropractic, Inc. | Chiropractor | 1014 Eagleridge Blvd, Unit B, Pueblo, CO 81008-2165 | 2016-02-19 |
| 1760728117 | Bellah Chiropractic Center, P.C. | Chiropractor | 824 W Abriendo Ave, Pueblo, CO 81004-1547 | 2012-12-12 |
| 1629326905 | Derek Wade Stickler | Chiropractor | 2447 S Prairie Ave, Pueblo, CO 81005-2886 | 2012-08-17 |
| 1679840029 | Donald G Dressen D C P C | Chiropractor | 725 Desert Flower Blvd Ste B, Pueblo, CO 81001-1268 | 2011-11-29 |
| 1033400510 | Theodore W Davis | Chiropractor | 2505 Kachina Dr, Pueblo, CO 81008-1573 | 2011-05-02 |
| 1255667440 | Jeffrey Paul Johnson | Chiropractor | 4112 Outlook Blvd 255, Pueblo, CO 81008-1667 | 2009-10-23 |
| 1114160330 | Charlotte Winnette Fleming | Chiropractor | 255 W. Abriendo Ave., Pueblo, CO 81004-1870 | 2009-04-17 |
| 1386869659 | Catherine L Brunetto | Chiropractor | 540 E Abriendo Ave Ste F, Pueblo, CO 81004-2388 | 2007-04-13 |
| 1699897603 | Gregg Loren Riggert | Chiropractor | 24 Club Manor Dr Ste 108, Pueblo, CO 81008-1699 | 2007-04-03 |
| 1215061908 | A and A Chiropractic Center LLC | Chiropractor | 635 W Corona Ave, Suite 103, Pueblo, CO 81004-1242 | 2007-03-15 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.