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General NPI Number Information
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NPI Number | 1174834600
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR PERFORMANCE AND POTENTIAL LLC
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 1054 31ST ST NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20007-4403
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Country | US
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Telephone | 202-944-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 1054 31ST ST NW SUITE 210
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City | WASHINGTON
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State | DC
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Zip | 20007-4403
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Country | US
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Telephone | 202-944-9888
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. GABRIELLE SHAUGHNESS
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Credential | D,C,
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Telephone | 202-944-9888
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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 | CH030092
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License Number State | DC
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