National Provider Identifier Database

CHARLES J PETERSON DC PC
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.


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
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for CHARLES J PETERSON DC PC

NPI Number 1083687636
Legal business name
LBN
CHARLES J PETERSON DC PC
Authorized official CHARLES PETERSON - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 02/13/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 04065
  • IA Medicaid: 0015271
  • IA Other: 01527 WELLMARK

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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