Provider Demographics
NPI:1235562919
Name:PAELTZ, JUSTIN PHILLIP (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:PHILLIP
Last Name:PAELTZ
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 1:7500 BOULEVARD 26
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8318
Mailing Address - Country:US
Mailing Address - Phone:817-259-1300
Mailing Address - Fax:817-284-8240
Practice Address - Street 1:7500 BOULEVARD 26
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8318
Practice Address - Country:US
Practice Address - Phone:817-259-1300
Practice Address - Fax:817-284-8240
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor