Provider Demographics
NPI:1174985659
Name:PELTIER, JODI (DAOM, LAC)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:PELTIER
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 SUNRISE CIR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3038
Mailing Address - Country:US
Mailing Address - Phone:651-755-8077
Mailing Address - Fax:
Practice Address - Street 1:270 SUNRISE CIR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3038
Practice Address - Country:US
Practice Address - Phone:651-755-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2024-12-16
Deactivation Date:2024-05-28
Deactivation Code:
Reactivation Date:2024-08-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist