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General NPI Number Information
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NPI Number | 1194063032
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Entity Type | Organization
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Legal Business Name | PEAK PERFORMANCE HEALTH PA
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 10111 E 21ST ST #106
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City | WICHITA
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State | KS
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Zip | 67206
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Country | US
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Telephone | 316-990-7838
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Fax | 316-260-9019
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Provider Business Mailing Address
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Address Line | 10111 E 21ST ST #106
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City | WICHITA
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State | KS
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Zip | 67206
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Country | US
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Telephone | 316-990-7838
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Fax | 316-260-9019
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Authorized Official
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Title or Position | CEO
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Name | STEVEN PAUL HOWARD
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Credential | D.C.
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Telephone | 316-990-7838
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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 | 0105383
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License Number State | KS
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