Provider Demographics
NPI:1528822970
Name:PETRON, CHASE EUGENE (DC)
Entity type:Individual
Prefix:DR
First Name:CHASE
Middle Name:EUGENE
Last Name:PETRON
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 1:7610 PENN AVE S APT D203
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-3666
Mailing Address - Country:US
Mailing Address - Phone:763-325-3005
Mailing Address - Fax:
Practice Address - Street 1:14635 PENNOCK AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55124-6587
Practice Address - Country:US
Practice Address - Phone:952-432-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor