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General NPI Number Information
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NPI Number | 1023348653
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Entity Type | Organization
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Legal Business Name | PERFORMANCE CHIROPRACTIC & SPORTS CARE, INC.
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 01/04/2010
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Provider Practice Location Address
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Address Line | 1707 PROFESSIONAL DR
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City | SACRAMENTO
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State | CA
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Zip | 95825-2104
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Country | US
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Telephone | 916-483-6722
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Fax | 916-488-0790
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Provider Business Mailing Address
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Address Line | 1707 PROFESSIONAL DR
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City | SACRAMENTO
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State | CA
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Zip | 95825-2104
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Country | US
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Telephone | 916-483-6722
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Fax | 916-488-0790
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YONG J. KIM
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Credential | D.C.
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Telephone | 916-483-6722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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