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Individual

DR. KEVIN JAY PELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
730 KINGSTOWN RD STE 3, WAKEFIELD, RI 02879-3002
(401) 782-8380
(401) 782-3650
Mailing address
730 KINGSTOWN RD STE 3, WAKEFIELD, RI 02879-3002
(401) 782-8380
(401) 782-3650

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC332
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000332
RI
01
44-00023
UHC
RI
01
9145-5
BLUE CROSS BLUE SHIELD RI
RI
Enumeration date
10/19/2006
Last updated
07/08/2007
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