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Contact Information

PERFORMANCE CHIROPRACTIC LLC
825 S HURON RD STE H
GREEN BAY, WI54311-8029
 Phone: 920-406-8700
 Fax: 920-406-8712
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for PERFORMANCE CHIROPRACTIC LLC

NPI # 1336292614
LBN Legal business name PERFORMANCE CHIROPRACTIC LLC
Authorized official TIMOTHY BELLEAU - (DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/19/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
WI License # 2670-012
WI Medicaid 38868000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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