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Contact Information

CHARLES J PETERSON DC PC
1203 W SHERIDAN AVE
SHENANDOAH, IA51601
 Phone: 712-246-4798
 Fax: 712-246-5613
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for CHARLES J PETERSON DC PC · (Female)

NPI # 1083687636
Status Active
Credentials
Entity Individual
Enumeration date 02/13/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • IA License # 04065
  • IA Medicaid 0015271
  • IA Other 01527 WELLMARK
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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