Organization
CAFE OF LIFE FENTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERICA MARIE PEABODY D.C. (OWNER)
(810) 629-6023
Entity
Organization
Contact information
Practice address
114 W CAROLINE ST, FENTON, MI 48430-3802
(810) 629-6023
(810) 629-6024
Mailing address
114 W CAROLINE ST, FENTON, MI 48430-3802
(810) 629-6023
(810) 629-6024
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008978
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000662
—
MI
Enumeration date
04/23/2007
Last updated
08/22/2020
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