Healthcare Provider Details

I. General information

NPI: 1629994702
Provider Name (Legal Business Name): PERFORM WELLNESS AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BEACHWAY DR STE 308
INDIANAPOLIS IN
46224-7876
US

IV. Provider business mailing address

777 BEACHWAY DR STE 202
INDIANAPOLIS IN
46224-7877
US

V. Phone/Fax

Practice location:
  • Phone: 317-617-9644
  • Fax:
Mailing address:
  • Phone: 317-617-9644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER THOMAS CHISLER
Title or Position: OWNER
Credential: DDS
Phone: 317-617-9644