Healthcare Provider Details

I. General information

NPI: 1194706549
Provider Name (Legal Business Name): ARNE G PELTO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 12/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 WESTMINSTER ST
PROVIDENCE RI
02909-1412
US

IV. Provider business mailing address

1345 WESTMINSTER ST
PROVIDENCE RI
02909-1412
US

V. Phone/Fax

Practice location:
  • Phone: 401-228-7766
  • Fax: 401-228-7707
Mailing address:
  • Phone: 401-228-7766
  • Fax: 401-228-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2083
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP00605
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: