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General NPI Number Information
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NPI Number | 1215752233
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Entity Type | Organization
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Legal Business Name | PEAK PERFORMANCE SPORT & SPINE LLC
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 2265 W FAIR AVE
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City | LANCASTER
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State | OH
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Zip | 43130-8821
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Country | US
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Telephone | 740-494-1470
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Fax | 740-494-1471
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Provider Business Mailing Address
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Address Line | 2265 W FAIR AVE
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City | LANCASTER
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State | OH
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Zip | 43130-8821
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Country | US
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Telephone | 740-494-1470
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Fax | 740-494-1471
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHAD D. HEDGES
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Credential | DC, MS, CCSP
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Telephone | 740-503-8911
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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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