Provider Demographics
NPI:1275681777
Name:PEAK PERFORMANCE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:PEAK PERFORMANCE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-786-7325
Mailing Address - Street 1:275 HILL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1812
Mailing Address - Country:US
Mailing Address - Phone:775-786-7325
Mailing Address - Fax:775-786-7340
Practice Address - Street 1:275 HILL ST STE 101
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1812
Practice Address - Country:US
Practice Address - Phone:775-786-7325
Practice Address - Fax:775-786-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV103789OtherGROUP PIN