Individual
PHILIP PELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 ROMENCE RD, PORTAGE, MI 49024-3439
(269) 324-0800
(269) 324-0894
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005543
MI
Other
Enumeration date
05/05/2021
Last updated
11/14/2025
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