Provider Demographics
NPI:1629666599
Name:PEET CHIROPRACTIC HEALTH CORPORATION
Entity Type:Organization
Organization Name:PEET CHIROPRACTIC HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PALMER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEET
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-922-4955
Mailing Address - Street 1:26933 CAMINO DE ESTRELLA STE B
Mailing Address - Street 2:
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624-1680
Mailing Address - Country:US
Mailing Address - Phone:802-922-4955
Mailing Address - Fax:
Practice Address - Street 1:26933 CAMINO DE ESTRELLA STE B
Practice Address - Street 2:
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624-1680
Practice Address - Country:US
Practice Address - Phone:802-922-4955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty