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General NPI Number Information
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NPI Number | 1346370384
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Entity Type | Individual
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Provider Name | PETER J FAGERLAND D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 11/13/2022
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Provider Practice Location Address
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Address Line | 110 BOGGS LN STE 286
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City | CINCINNATI
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State | OH
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Zip | 45246-3145
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Country | US
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Telephone | 513-742-0002
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Fax | 513-239-8875
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Provider Business Mailing Address
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Address Line | 110 BOGGS LN STE 286
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City | CINCINNATI
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State | OH
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Zip | 45246-3145
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Country | US
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Telephone | 513-742-0002
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Fax | 513-239-8875
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 1696
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License Number State | OH
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