Healthcare Provider Details

I. General information

NPI: 1245150515
Provider Name (Legal Business Name): PEAK PERFORMANCE PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 COLORADO AVE STE A
PUEBLO CO
81004-2075
US

IV. Provider business mailing address

248 S CAMINO DE LOS RANCHOS
PUEBLO WEST CO
81007-4050
US

V. Phone/Fax

Practice location:
  • Phone: 941-228-8876
  • Fax:
Mailing address:
  • Phone: 941-228-8876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA N STEWART
Title or Position: OWNER
Credential: NP
Phone: 941-228-8876