Provider Demographics
NPI:1760634497
Name:PETERS, CHAD A (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:A
Last Name:PETERS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:26455 ROCKWELL CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1803
Mailing Address - Country:US
Mailing Address - Phone:661-362-3491
Mailing Address - Fax:661-255-2972
Practice Address - Street 1:26455 ROCKWELL CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1803
Practice Address - Country:US
Practice Address - Phone:661-362-3491
Practice Address - Fax:661-255-2972
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer