Provider Demographics
NPI:1922109925
Name:PEAK PERFORMANCE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:PEAK PERFORMANCE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:LIMTIACO
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-737-5433
Mailing Address - Street 1:3427 WAIALAE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2619
Mailing Address - Country:US
Mailing Address - Phone:808-779-6688
Mailing Address - Fax:808-737-4324
Practice Address - Street 1:3427 WAIALAE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2619
Practice Address - Country:US
Practice Address - Phone:808-779-6688
Practice Address - Fax:808-737-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty