Provider Demographics
NPI:1427719913
Name:PETERS, ABIGAIL MARY (DC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARY
Last Name:PETERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ENGLEWOOD PKWY APT G207
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2397
Mailing Address - Country:US
Mailing Address - Phone:412-953-8291
Mailing Address - Fax:
Practice Address - Street 1:1890 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6804
Practice Address - Country:US
Practice Address - Phone:720-458-0487
Practice Address - Fax:720-458-0981
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0008480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCHR0008480OtherCHIROPRACTIC LICENSE