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General NPI Number Information
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NPI Number | 1568884781
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Entity Type | Organization
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Legal Business Name | PEEKS CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 401 N BOONE ST
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City | JOHNSON CITY
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State | TN
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Zip | 37604-5607
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Country | US
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Telephone | 423-928-2251
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Fax | 423-928-2002
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Provider Business Mailing Address
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Address Line | 401 N BOONE ST
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City | JOHNSON CITY
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State | TN
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Zip | 37604-5607
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Country | US
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Telephone | 423-928-2251
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Fax | 423-928-2002
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Authorized Official
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Title or Position | OFFIC MANAGER
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Name | MRS. BONNI BRAKE WOLLARD
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Credential |
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Telephone | 423-928-2251
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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 | DC0000000130
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License Number State | TN
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