Provider Demographics
NPI:1104804954
Name:PELCHAT, GUY YVES (DC)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:YVES
Last Name:PELCHAT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 N WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2038
Mailing Address - Country:US
Mailing Address - Phone:321-242-7721
Mailing Address - Fax:321-242-7679
Practice Address - Street 1:6550 N WICKHAM RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2038
Practice Address - Country:US
Practice Address - Phone:321-242-7721
Practice Address - Fax:321-242-7679
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55206Medicare ID - Type Unspecified