Provider Demographics
NPI:1861808735
Name:PEACEFUL HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:PEACEFUL HEALTH AND WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR, CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:DIERKSEN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-951-9355
Mailing Address - Street 1:200 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3938
Mailing Address - Country:US
Mailing Address - Phone:972-951-9355
Mailing Address - Fax:972-421-8203
Practice Address - Street 1:200 N MILL ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3938
Practice Address - Country:US
Practice Address - Phone:972-951-9355
Practice Address - Fax:972-421-8203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12524111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty