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NPI Profile for PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC in GRAND RAPIDS, MN.
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Chiropractor |
111N00000X | 35 | Chiropractic |
| NPI # | 1487745477 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/27/2006 | |
| Last updated | 10/31/2013 - About 13 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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| Hospital affiliation(s) | Not Available |
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PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC