MEDICARE: PEAK CHIROPRACTIC, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3974	OR

General Provider Information

NPI Number	:	1215381504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK CHIROPRACTIC, INC

Provider Business Mailing Address
First Line	:	10355 NW GLENCOE RD STE B
Second Line	:
City	:	NORTH PLAINS
State	:	OR
Zip	:	97133-8244
Country	:	US
Telephone Number	:	971-254-9988
Fax Number	:	971-239-1906

Provider Business Practice Location Address
First Line	:	10355 NW GLENCOE RD STE B
Second Line	:
City	:	NORTH PLAINS
State	:	OR
Zip	:	97133-8244
Country	:	US
Telephone Number	:	971-254-9988
Fax Number	:	971-239-1906

Authorized Official
Title or Position	:	CEO
Name	:	DR. LEIF LLOYD LENSGRAF
Credential	:	D.C.
Telephone Number	:	971-254-9988

Provider Enumeration Date	:	04/22/2016
Last Update Date	:	04/24/2024

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