Provider Demographics
NPI:1982199782
Name:PEETE, KOREY SR
Entity Type:Individual
Prefix:
First Name:KOREY
Middle Name:
Last Name:PEETE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 ASCOT AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-3613
Mailing Address - Country:US
Mailing Address - Phone:614-999-2129
Mailing Address - Fax:
Practice Address - Street 1:342 ASCOT AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-3613
Practice Address - Country:US
Practice Address - Phone:614-999-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health