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General NPI Number Information
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NPI Number | 1013283696
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Entity Type | Individual
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Provider Name | MICHELLE NICOLE PETERS D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 3330 MATLOCK RD SUITE 206
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City | ARLINGTON
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State | TX
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Zip | 76015-2921
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Country | US
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Telephone | 817-465-2225
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Fax | 817-719-9342
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Provider Business Mailing Address
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Address Line | 3330 MATLOCK RD STE 206
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City | ARLINGTON
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State | TX
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Zip | 76015-2921
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Country | US
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Telephone | 817-465-2225
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Fax | 817-719-9342
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9678
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License Number State | TX
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