Provider Demographics
NPI:1437351392
Name:PEAK PERFORMANCE HEALTH MGMT., LLC
Entity Type:Organization
Organization Name:PEAK PERFORMANCE HEALTH MGMT., LLC
Other - Org Name:MERRIMACK FAMILY CHIROPRACTIC, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-673-0010
Mailing Address - Street 1:89 ROUTE 101A
Mailing Address - Street 2:SUITE 3
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031
Mailing Address - Country:US
Mailing Address - Phone:603-673-0010
Mailing Address - Fax:603-673-2366
Practice Address - Street 1:89 ROUTE 101A
Practice Address - Street 2:SUITE 3
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031
Practice Address - Country:US
Practice Address - Phone:603-673-0010
Practice Address - Fax:603-673-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH111-1092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3122Medicare ID - Type Unspecified