Provider Demographics
NPI:1730447533
Name:PEAK PERFORMANCE CHIROPRACTIC CENTERS, L.L.C.
Entity type:Organization
Organization Name:PEAK PERFORMANCE CHIROPRACTIC CENTERS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:MERRITT
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-288-0678
Mailing Address - Street 1:1027 BARLEY DR
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-9469
Mailing Address - Country:US
Mailing Address - Phone:229-288-0678
Mailing Address - Fax:912-320-4587
Practice Address - Street 1:212 FRASER DR
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3711
Practice Address - Country:US
Practice Address - Phone:912-408-2121
Practice Address - Fax:912-320-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty