Individual
ERIC JOHN PELTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
898 322ND AVE NE, CAMBRIDGE, MN 55008-5810
(763) 234-3308
Mailing address
898 322ND AVE NE, CAMBRIDGE, MN 55008-5810
(763) 234-3308
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
1103722
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103722
MN ADULT FOSTER CARE LICENSE
MN
01
—
1104550
MN DHS 245D LICENSE - ADULT FOSTER CARE LICENSE
MN
Enumeration date
06/10/2020
Last updated
06/10/2020
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