Provider Demographics
NPI:1336682715
Name:PETERS, ALEXANDAR JOSHUA (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDAR
Middle Name:JOSHUA
Last Name:PETERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6592 N DECATUR BLVD
Mailing Address - Street 2:#115
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1037
Mailing Address - Country:US
Mailing Address - Phone:702-396-4993
Mailing Address - Fax:702-636-4990
Practice Address - Street 1:6592 N DECATUR BLVD
Practice Address - Street 2:#115
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1037
Practice Address - Country:US
Practice Address - Phone:702-396-4993
Practice Address - Fax:702-636-4990
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor