Individual
JACOB PELTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 CORA DR, BATON ROUGE, LA 70815-4201
(225) 387-1611
Mailing address
150 CORA DR, BATON ROUGE, LA 70815-4201
(225) 387-1611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
LA
01
—
RAC-5050
LAADRA
LA
Enumeration date
11/27/2018
Last updated
05/06/2021
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