National Provider Identifier Database

PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC
Chiropractor

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.


Contact Information

PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC
104 NE 3RD ST
SUITE 220
GRAND RAPIDS, MN55744
Phone: 218-326-0604
Fax: 218-326-1509
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC

NPI Number 1487745477
Legal business name
LBN
PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC
Authorized official ADAM ZACHMAN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/27/2006
Last updated 10/31/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 4472
  • MN Medicaid: 120187500

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC

There are currently no reviews for PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC


NPIdb - Home
v2.201