Individual
ALISA PEACOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6055 E WASHINGTON BLVD, COMMERCE, CA 90040-2449
(323) 346-0960
Mailing address
11515 FIRESTONE BLVD, NORWALK, CA 90650-2804
(562) 864-2587
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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