CORRIE JOESPH PELTIER

STACY, MN
NPI1114070406
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy324500000X Substance Abuse Rehabilitation Facility
(Licence: MN  1032392-1-CDT)
Enumeration Date2007-01-19
Last Update Date2007-07-08
Business Address
-- CORRIE JOESPH PELTIER LADC
31065 FOREST BLVD.
STACY, MN 55079
Phone number: 650-408-7121
Mailing Address
-- CORRIE JOESPH PELTIER LADC
PO BOX 30
STACY, MN 55079-0030
Phone number: 651-408-7121