Healthcare Provider Details

I. General information

NPI: 1568117901
Provider Name (Legal Business Name): PEAK BRAIN PERFORMANCE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 02/15/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4740 FINTRIDGE DR. SUITE 220
COLORADO SPRINGS CO
80918-4253
US

IV. Provider business mailing address

4740 FINTRIDGE DR. SUITE 220
COLORADO SPRINGS CO
80918-4253
US

V. Phone/Fax

Practice location:
  • Phone: 719-208-4314
  • Fax: 719-960-2192
Mailing address:
  • Phone: 719-208-4314
  • Fax: 719-960-2192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW ARTHUR SHEM
Title or Position: OWNER
Credential: DC, DACNB
Phone: 719-208-4314