Most Relevant Information
Provider Data
| NPI Number: | 1003457466 |
| Provider Name: | JORDAN MATTHEW PETERSON DC |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | CH60990272 |
Most Important Dates
| Enumeration Date: | 10/07/2019 |
| Last Updated: | 10/07/2019 |
Provider Practice Location
103 N 1ST ST
ELMA
WA
985419854
Practice Location Phone/Fax
| Phone: | 3604825155 |
| Fax: |
Provider Mailing Location
PO BOX 656
ELMA
WA
985410656
Provider Mailing Phone/Fax
| Phone: | 3604825155 |
| Fax: | 3604824155 |