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Dr. Anicia Gwen Peterson, DC
Chiropractor in Crosslake, Minnesota
NPI 1003973702

Anicia Gwen Peterson is a Chiropractor based in Crosslake, MN. Anicia Gwen Peterson practices in Crosslake, MN and has the professional credentials of DC. The NPI Number for Anicia Gwen Peterson is 1003973702 and holds a License No. 3138 (Minnesota).

The current practice location address for Anicia Gwen Peterson is 13743 E Shore Rd, Crosslake, MN and can be reached out via phone at 218-692-1616 and via fax at 218-692-1626.

Location: 13743 E Shore Rd, Crosslake, MN, 56442-4033
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003973702
Provider Name
Anicia Gwen Peterson
Credential
DC
Provider Entity Type
Individual
Gender
Female
Address
13743 E Shore Rd, Crosslake, MN, 56442-4033
Phone Number
218-692-1616
Fax Number
218-692-1626
Provider Enumeration Date
01/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
68D24NO 01 MN BCBS OFFICE ID #
68D25PE 01 MN BCBS INDIVIDUAL ID #
institution
Provider Business Practice Location Address Details
Address
13743 E Shore Rd
City
Crosslake
State
Minnesota
Zip
56442-4033
Phone Number
218-692-1616
Fax Number
218-692-1626
person
Provider Business Mailing Address Details
Address
13743 E Shore Rd
City
Crosslake
State
Minnesota
Zip
56442-4033
Phone Number
218-692-1616
Fax Number
218-692-1626
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
3138 (Minnesota)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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