Peterson, Matthew Wade

Peterson, Matthew Wade is an individual health care provider with primary practice located at 10456 S Redwood Rd , South Jordan UT 84095-8501. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Peterson, Matthew Wade can be contacted via phone (801) 878-9565.

Contact Information

Primary practice address
10456 S Redwood Rd South Jordan UT 84095-8501
Phone: (801) 878-9565
Fax: (801) 432-8072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 370378-1202 Utah

Profile Details

NPI number 1326011891
LBN Legal business name Peterson, Matthew Wade
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Nov 19th, 2012 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326011891 NPPES
Utah MEDICAID 870395551005

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