Individual
KEITH ALLEN PELTIER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
6965 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8231
(423) 869-6560
Mailing address
6965 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8231
(423) 869-6560
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2288
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2288
ATHLETIC TRAINER
TN
Enumeration date
03/23/2020
Last updated
03/23/2020
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