Provider Demographics
NPI:1609802966
Name:PEACE, LIVIA ANNE (ATC)
Entity Type:Individual
Prefix:
First Name:LIVIA
Middle Name:ANNE
Last Name:PEACE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5622 S HURRICANE CT
Mailing Address - Street 2:#D
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2067
Mailing Address - Country:US
Mailing Address - Phone:520-271-7889
Mailing Address - Fax:
Practice Address - Street 1:5622 S HURRICANE CT
Practice Address - Street 2:#D
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2067
Practice Address - Country:US
Practice Address - Phone:520-271-7889
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer