Healthcare Provider Details

I. General information

NPI: 1649560574
Provider Name (Legal Business Name): PEACE IS AT HAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3053 ELMWOOD CT
ATLANTA GA
30349-8102
US

IV. Provider business mailing address

3053 ELMWOOD CT
ATLANTA GA
30349-8102
US

V. Phone/Fax

Practice location:
  • Phone: 678-755-3601
  • Fax:
Mailing address:
  • Phone: 678-755-3601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberMT001943
License Number StateGA

VIII. Authorized Official

Name: MS. SHERRIE CHARMANIE THORNHILL
Title or Position: LICENSED MASSAGE THERAPIST
Credential: LMT
Phone: 678-755-3601