Organization
PELTAN OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA IVENS PELTAN (PARTNER)
66254544600
Entity
Organization
Contact information
Practice address
425B N DAVIS AVE, CLEVELAND, MS 38732-2351
(662) 545-4600
(662) 545-4595
Mailing address
425B N DAVIS AVE, CLEVELAND, MS 38732-2351
(662) 545-4600
(662) 545-4595
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20927
MS
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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