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Organization
PELT EYE CLINIC, P.A.
Active
Organization
PELT EYE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN E PELT OD (PRESIDENT)
(850) 482-2336
Entity
Organization
Contact information
Practice address
4340 LAFAYETTE ST, MARIANNA, FL 32446-2916
(850) 482-2336
(850) 526-5337
Mailing address
PO BOX 6054, MARIANNA, FL 32447-6054
(850) 482-2336
(850) 526-5337
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620847900
—
FL
Enumeration date
07/10/2006
Last updated
03/28/2008
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