Provider Demographics
NPI:1992319545
Name:PETERSON, CONNOR NEAL (DC)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:NEAL
Last Name:PETERSON
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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:STROMSBURG
Mailing Address - State:NE
Mailing Address - Zip Code:68666-0306
Mailing Address - Country:US
Mailing Address - Phone:402-764-0494
Mailing Address - Fax:
Practice Address - Street 1:208 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:STROMSBURG
Practice Address - State:NE
Practice Address - Zip Code:68666-3024
Practice Address - Country:US
Practice Address - Phone:402-764-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2030111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology