Peterson, Glen R

Peterson, Glen R is an individual health care provider with primary practice located at 501 1St St , La Salle IL 61301-2416. He recently has only one registered license in Chiropractic Providers / Sports Physician, which is considered as his primary health care specialty. Peterson, Glen R can be contacted via phone (815) 223-4201.

Contact Information

Primary practice address
501 1St St La Salle IL 61301-2416
Phone: (815) 223-4201
Fax: (814) 223-4210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 038-008373 Illinois

Profile Details

NPI number 1437209418
LBN Legal business name Peterson, Glen R
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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