Peaceful Provider Llc | |
1818 La Plz Ste 104 Cotati CA 94931-5216 | |
(707) 634-4487 | |
Not Available |
Full Name | Peaceful Provider Llc |
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Speciality | Clinic/center |
Location | 1818 La Plz Ste 104, Cotati, California |
Authorized Official Name and Position | Demetra Markis (CEO) |
Authorized Official Contact | 7076344487 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Peaceful Provider Llc 1818 La Plz Ste 104 Cotati CA 94931-5216 Ph: (707) 634-4487 | Peaceful Provider Llc 1818 La Plz Ste 104 Cotati CA 94931-5216 Ph: (707) 634-4487 |
NPI Number | 1992500995 |
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Provider Enumeration Date | 02/14/2025 |
Last Update Date | 02/14/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992500995 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |