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General NPI Number Information
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NPI Number | 1174911408
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Entity Type | Individual
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Provider Name | ZACHARY COLE PETERSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2015
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 615 MAIN ST # 768
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City | FRANKFORT
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State | MI
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Zip | 49635
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Country | US
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Telephone | 232-994-3688
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Fax |
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Provider Business Mailing Address
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Address Line | 615 MAIN ST # 768
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City | FRANKFORT
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State | MI
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Zip | 49635-9806
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Country | US
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Telephone | 231-994-3688
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Fax |
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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 | 2301010410
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License Number State | MI
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