Provider Demographics
NPI:1639502925
Name:PETER, CLEOPATRA (DC)
Entity Type:Individual
Prefix:DR
First Name:CLEOPATRA
Middle Name:
Last Name:PETER
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 1:4500 SION FARM STE 8B
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820
Mailing Address - Country:US
Mailing Address - Phone:340-713-2225
Mailing Address - Fax:888-686-4557
Practice Address - Street 1:4500 SION FARM STE 8B
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4423
Practice Address - Country:US
Practice Address - Phone:340-713-2225
Practice Address - Fax:888-686-4557
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009177111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician