Provider Demographics
NPI:1013144542
Name:MAXIMUM PERFORMANCE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:MAXIMUM PERFORMANCE CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:BENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-268-6080
Mailing Address - Street 1:5430 PINNACLE POINT DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1492
Mailing Address - Country:US
Mailing Address - Phone:479-268-6080
Mailing Address - Fax:479-268-6083
Practice Address - Street 1:5430 PINNACLE POINT DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1492
Practice Address - Country:US
Practice Address - Phone:479-268-6080
Practice Address - Fax:479-268-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty