Provider Demographics
NPI:1518181833
Name:PETERSON, DREW LELAND (DC)
Entity type:Individual
Prefix:MR
First Name:DREW
Middle Name:LELAND
Last Name:PETERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11225 ESTIA DR UNIT 63
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-2382
Mailing Address - Country:US
Mailing Address - Phone:303-746-6797
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:5560 BEE RIDGE RD STE 7
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1509
Practice Address - Country:US
Practice Address - Phone:941-927-1123
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty