Provider Demographics
NPI:1184470825
Name:PEAK POTENTIAL CHIROPRACTIC AND PHYSICAL THERAPY
Entity type:Organization
Organization Name:PEAK POTENTIAL CHIROPRACTIC AND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MIKELA
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-280-0245
Mailing Address - Street 1:334 LOCUST THORN CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1858
Mailing Address - Country:US
Mailing Address - Phone:607-280-0245
Mailing Address - Fax:
Practice Address - Street 1:650 RITCHIE HWY STE 106
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3910
Practice Address - Country:US
Practice Address - Phone:410-421-5544
Practice Address - Fax:410-421-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty