Provider Demographics
NPI:1174834600
Name:INSTITUTE FOR PERFORMANCE AND POTENTIAL LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR PERFORMANCE AND POTENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAUGHNESS
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:202-944-9888
Mailing Address - Street 1:1054 31ST ST NW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4403
Mailing Address - Country:US
Mailing Address - Phone:202-944-9888
Mailing Address - Fax:
Practice Address - Street 1:1054 31ST ST NW
Practice Address - Street 2:SUITE 210
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-4403
Practice Address - Country:US
Practice Address - Phone:202-944-9888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty