Provider Demographics
NPI:1700376340
Name:PEAK CHIROPRACTIC INC.
Entity type:Organization
Organization Name:PEAK CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:WENINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-527-4380
Mailing Address - Street 1:1684 CAPITOL WAY
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-2193
Mailing Address - Country:US
Mailing Address - Phone:701-751-0642
Mailing Address - Fax:701-751-1717
Practice Address - Street 1:1684 CAPITOL WAY
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-2193
Practice Address - Country:US
Practice Address - Phone:701-751-0642
Practice Address - Fax:701-751-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty