Provider Demographics
NPI:1578107850
Name:PERFORMANCE HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:PERFORMANCE HEALTH SOLUTIONS
Other - Org Name:HEALTHSOURCE OF SE OVERLAND PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-491-6300
Mailing Address - Street 1:7401 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3904
Mailing Address - Country:US
Mailing Address - Phone:913-544-6888
Mailing Address - Fax:
Practice Address - Street 1:14864 METCALF AVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2206
Practice Address - Country:US
Practice Address - Phone:913-656-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty