Provider Demographics
NPI:1194706549
Name:PELTO, ARNE G (DC)
Entity type:Individual
Prefix:DR
First Name:ARNE
Middle Name:G
Last Name:PELTO
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 1:1345 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1412
Mailing Address - Country:US
Mailing Address - Phone:401-228-7766
Mailing Address - Fax:401-228-7707
Practice Address - Street 1:1345 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1412
Practice Address - Country:US
Practice Address - Phone:401-228-7766
Practice Address - Fax:401-228-7707
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2083111N00000X
RIDCP00605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABCBSOtherY36456
MABCBSOtherY36456
MAY4507901Medicare PIN
MAY45079Medicare PIN