Healthcare Provider Details

I. General information

NPI: 1144031675
Provider Name (Legal Business Name): PEAK PERFORMANCE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12750 NICOLLET AVE STE 303
BURNSVILLE MN
55337-4094
US

IV. Provider business mailing address

12750 NICOLLET AVE STE 303
BURNSVILLE MN
55337-4094
US

V. Phone/Fax

Practice location:
  • Phone: 507-476-7345
  • Fax:
Mailing address:
  • Phone: 952-807-9914
  • Fax: 952-807-9928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. HALEY NICOLE BALEGO
Title or Position: PARTNER
Credential: D.C.
Phone: 612-380-6111