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General NPI Number Information
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NPI Number | 1497997027
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Entity Type | Organization
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Legal Business Name | PEAK PERFORMANCE REHABILITATION AND WELLNESS CENTER, PLLC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 3266 CHIMNEY ROCK RD
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City | ABILENE
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State | TX
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Zip | 79606-3356
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Country | US
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Telephone | 325-692-7400
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Fax | 325-692-7402
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Provider Business Mailing Address
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Address Line | 3266 CHIMNEY ROCK RD
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City | ABILENE
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State | TX
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Zip | 79606-3356
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Country | US
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Telephone | 325-692-7400
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Fax | 325-692-7402
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Authorized Official
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Title or Position | CHIROPRACTOR/CO-OWNER
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Name | DR. JACQUELINE C WEAVER
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Credential | D.C.
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Telephone | 713-503-3835
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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 | 11139
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10825
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License Number State | TX
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