Provider Demographics
NPI:1912748757
Name:PELTIER, STANLEY JOSEPH III (DC)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:JOSEPH
Last Name:PELTIER
Suffix:III
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 1:2903 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3135
Mailing Address - Country:US
Mailing Address - Phone:612-722-2147
Mailing Address - Fax:612-722-1581
Practice Address - Street 1:2903 E 42ND ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3135
Practice Address - Country:US
Practice Address - Phone:612-722-2147
Practice Address - Fax:612-722-1581
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor