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NPI Code Detail

MEDICARE: JOHN PETERS DC

MEDICARE: JOHN PETERS DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor5590KY

General Provider Information

NPI Number : 1902360449
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN PETERS DC
Provider Business Mailing Address
First Line : 457 KEENE CENTRE DR
Second Line :
City : NICHOLASVILLE
State : KY
Zip : 40356-1492
Country : US
Telephone Number : 859-241-6003
Fax Number : 859-241-6071
Provider Business Practice Location Address
First Line : 457 KEENE CENTRE DR
Second Line :
City : NICHOLASVILLE
State : KY
Zip : 40356-1492
Country : US
Telephone Number : 859-241-6003
Fax Number : 859-241-6071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2019
Last Update Date : 10/06/2022

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Directions to “ JOHN PETERS DC” Practice Location

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