Individual provider · Type 1 NPI
Anicia Gwen Peterson, DC
Chiropractor · Crosslake, MN
NPI number
1003973702
Active
Practice location
13743 E Shore Rd
Crosslake, MN 56442-4033
Fax (218) 692-1626
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 3138 (MN) |
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.
Another provider at this address
About NPI 1003973702
Anicia Gwen Peterson, DC's National Provider Identifier is 1003973702, issued on Jan 2, 2007. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Crosslake, MN. The record was last updated on Jul 9, 2007.