| Petracore Wellness Llc | |
|
1577 Raymond Dr Apt 104 Naperville IL 60563-9702 | |
| (219) 242-1451 | |
| Not Available |
| Full Name | Petracore Wellness Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1577 Raymond Dr Apt 104, Naperville, Illinois |
| Authorized Official Name and Position | Stephanie Lynn Clymer (OWNER) |
| Authorized Official Contact | 2192421451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petracore Wellness Llc 1577 Raymond Dr Apt 104 Naperville IL 60563-9702 Ph: (219) 242-1451 | Petracore Wellness Llc 1577 Raymond Dr Apt 104 Naperville IL 60563-9702 Ph: (219) 242-1451 |
| NPI Number | 1770231037 |
|---|---|
| Provider Enumeration Date | 03/16/2022 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770231037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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