Doctor Name: | JANIE PEACHES |
NPI Number: | 1043501422 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | H.T. |
License Number: | |
Business Practice Address: | 167 North Main Street Optometry Dept Tuba City, AZ - 860450600 |
Business Phone Number: | 9282832748 |
Business Fax Number: | 9282832986 |
Mailing Address: | Po Box 600, Optometry Dept TUBA CITY |
State: | AZ |
Postal Code: | 860450600 |
Phone Number: | 9288232748 |
Fax Number: | 9282832986 |
NPI Enumeration Date: | 04/20/2011 |
NPI Last Update Date: | 04/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156F00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |