Provider Demographics
NPI:1952835613
Name:PEAK CHIROPRACTIC CARE, LLC
Entity Type:Organization
Organization Name:PEAK CHIROPRACTIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:769-216-3245
Mailing Address - Street 1:4915 I-55 NORTH
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39206
Mailing Address - Country:US
Mailing Address - Phone:769-216-3245
Mailing Address - Fax:769-216-3276
Practice Address - Street 1:4915 I-55 NORTH
Practice Address - Street 2:SUITE 201B
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206
Practice Address - Country:US
Practice Address - Phone:769-216-3245
Practice Address - Fax:769-216-3276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1238111N00000X
MS1236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty