Provider Demographics
NPI:1366448912
Name:PETERS, TROY HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:HENRY
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 1:1616 N LITCHFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-1252
Mailing Address - Country:US
Mailing Address - Phone:623-935-0911
Mailing Address - Fax:623-935-0921
Practice Address - Street 1:1616 N LITCHFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1287
Practice Address - Country:US
Practice Address - Phone:623-935-0911
Practice Address - Fax:623-935-0921
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7767111N00000X
CADC-29747111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition