Petersen Health & Wellness, Llc

NPI 1063459329 - Nursing Facility/Intermediate Care Facility - 313M00000X

NPI Details
NPI 1063459329
Enumeration Date 06/02/2006
Last Updated 10/09/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARK B. MARK
Position MANAGER
Phone (217) 428-7767
Fax (217) 428-7454
Practice Location
136 S DIPPER LN
DECATUR IL, 62522-1841, US
Phone (217) 428-7767
Fax (217) 428-7454
Business Location
830 W TRAILCREEK DR
PEORIA IL, 61614-1862, US
Phone (309) 691-8113
Fax (309) 691-8622
Toxanomy
Taxonomy Code 313M00000X
License State Illinois
License Number 0043455
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According to our database, Petersen Health & Wellness, Llc NPI is 1063459329, taxonomy code is 313M00000X and license number is 0043455, license state is located at Illinois. Petersen Health & Wellness, Llc physically located at 136 S Dipper Ln, Decatur IL, 62522-1841. NPI Number 1033115704 has the healthcare provider type.

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1063459329 NPI number is provided on an as is basis without warranty of any kind. 1063459329 is maintained by the National Plan & Provider Enumeration System. The contents of Petersen Health & Wellness, Llc are for informational purposes only.