Provider Demographics
NPI:1508809518
Name:PELTIER, DAVID S (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:PELTIER
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 1:355 BARKS RD EAST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302
Mailing Address - Country:US
Mailing Address - Phone:740-389-3330
Mailing Address - Fax:740-389-6880
Practice Address - Street 1:355 BARKS RD EAST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302
Practice Address - Country:US
Practice Address - Phone:740-389-3330
Practice Address - Fax:740-389-6880
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0853821Medicaid
OH0853821Medicaid
0709009Medicare PIN