Provider Demographics
NPI:1689985475
Name:MINDY H PELZ CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:MINDY H PELZ CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:H
Authorized Official - Last Name:PELZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-298-8092
Mailing Address - Street 1:115 PASEO DE SAN ANTONIO
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-3698
Mailing Address - Country:US
Mailing Address - Phone:408-298-8092
Mailing Address - Fax:
Practice Address - Street 1:115 PASEO DE SAN ANTONIO
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-3698
Practice Address - Country:US
Practice Address - Phone:408-298-8092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty