person
Dr. Nickalos Lee Peterson, DC
Chiropractor in Ridgefield, Connecticut
NPI 1598864282

Nickalos Lee Peterson is a Chiropractor based in Ridgefield, CT. Nickalos Lee Peterson practices in Ridgefield, CT and has the professional credentials of DC. The NPI Number for Nickalos Lee Peterson is 1598864282 and holds a License No. 180 (Connecticut).

The current practice location address for Nickalos Lee Peterson is 31 Bailey Ave, Ridgefield, CT and can be reached out via phone at 203-438-9609 and via fax at 203-438-7141.

Location: 31 Bailey Ave, Ridgefield, CT, 06877-4533
person
Provider Profile Details
NPI Number
1598864282
Provider Name
Nickalos Lee Peterson
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
31 Bailey Ave, Ridgefield, CT, 06877-4533
Phone Number
203-438-9609
Fax Number
203-438-7141
Provider Enumeration Date
09/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P405105 01 CT OXFORD PROVIDER ID NUMBER
4380815 01 CT AETNA PPO ID NUMBER
050000180CT01 01 CT ANTHEM BC/BS ID PROVIDER
LANDMARK /HEALTH NET 01 CT CT00180 PROVIDER ID#
9323280003 01 CT CIGNA PROVIDER ID NUMBER
0114667 01 CT AETNA HMO ID NUMBER
institution
Provider Business Practice Location Address Details
Address
31 Bailey Ave
City
State
Zip
06877-4533
Phone Number
203-438-9609
Fax Number
203-438-7141
person
Provider Business Mailing Address Details
Address
31 Bailey Ave
City
State
Zip
06877-4533
Phone Number
203-438-9609
Fax Number
203-438-7141
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
License No.
180 (Connecticut)
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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