Provider Demographics
NPI:1053862037
Name:NATURAL HEALTH & PERFORMANCE CHIROPRACTIC, LLC.
Entity Type:Organization
Organization Name:NATURAL HEALTH & PERFORMANCE CHIROPRACTIC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:KASUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-575-3852
Mailing Address - Street 1:3985 E BIJOU ST
Mailing Address - Street 2:APT C233
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-6846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:823 CHEYENNE MEADOWS RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4929
Practice Address - Country:US
Practice Address - Phone:719-268-0708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty