Provider Demographics
NPI:1003260977
Name:PEACEWORKS
Entity Type:Organization
Organization Name:PEACEWORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUZBACKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:612-965-0542
Mailing Address - Street 1:95 COACH LIGHT DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7770
Mailing Address - Country:US
Mailing Address - Phone:612-965-0563
Mailing Address - Fax:
Practice Address - Street 1:4820 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-2263
Practice Address - Country:US
Practice Address - Phone:612-965-0542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty