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General NPI Number Information
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NPI Number | 1336607050
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Entity Type | Organization
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Legal Business Name | PEAK POSTURE & PERFORMANCE PLLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 7253 W SUNSET AVE STE I
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City | SPRINGDALE
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State | AR
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Zip | 72762-0991
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Country | US
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Telephone | 870-805-5238
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Fax |
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Provider Business Mailing Address
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Address Line | 7253 W SUNSET AVE STE I
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City | SPRINGDALE
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State | AR
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Zip | 72762-0991
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD R VIRGIL
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Credential | DC
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Telephone | 870-805-5238
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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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