Provider Demographics
NPI:1346480613
Name:PEAK PERFORMANCE CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:PEAK PERFORMANCE CHIROPRACTIC INC.
Other - Org Name:PEAK PERFORMANCE CHIROPRACITIC & KINESIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:JAMESON
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:816-580-6119
Mailing Address - Street 1:201 E 6TH ST
Mailing Address - Street 2:PO BOX 406
Mailing Address - City:LAWSON
Mailing Address - State:MO
Mailing Address - Zip Code:64062-7804
Mailing Address - Country:US
Mailing Address - Phone:816-580-6119
Mailing Address - Fax:
Practice Address - Street 1:201 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWSON
Practice Address - State:MO
Practice Address - Zip Code:64062-7804
Practice Address - Country:US
Practice Address - Phone:816-580-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009002884261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center