Provider Demographics
NPI:1225286933
Name:PEAK PERFORMANCE CHIROPRACTIC CLINIC INC PS
Entity Type:Organization
Organization Name:PEAK PERFORMANCE CHIROPRACTIC CLINIC INC PS
Other - Org Name:WESTSOUND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:POCUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-550-2627
Mailing Address - Street 1:PO BOX 5842
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-0600
Mailing Address - Country:US
Mailing Address - Phone:360-830-6596
Mailing Address - Fax:
Practice Address - Street 1:3100 BUCKLIN HILL ROAD
Practice Address - Street 2:SUITE #105
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383
Practice Address - Country:US
Practice Address - Phone:360-830-6596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60018199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty