| 100 Chiro Peterson Walfoort, Llc | |
|
1921 Preston Rd Ste B2008, Plano, TX 75093-5124 | |
| (719) 252-8184 | |
| Not Available |
| Full Name | 100 Chiro Peterson Walfoort, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1921 Preston Rd Ste B2008, Plano, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083372767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Michael Peterson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811358997 PECOS PAC ID: 2860783636 Enrollment ID: I20230308000126 |
| Provider Name | Mary Clemens |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790549582 PECOS PAC ID: 1759725286 Enrollment ID: I20240222003751 |
| Mailing Address | Practice Location Address |
|---|---|
| 100 Chiro Peterson Walfoort, Llc 1921 Preston Rd Ste B2008, Plano, TX 75093-5124 Ph: (719) 252-8184 | 100 Chiro Peterson Walfoort, Llc 1921 Preston Rd Ste B2008, Plano, TX 75093-5124 Ph: (719) 252-8184 |
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