MEDICARE: PEAK PERFORMANCE CHIROPRACTIC & REHABILITATION

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	1667	NE

General Provider Information

NPI Number	:	1528352416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK PERFORMANCE CHIROPRACTIC & REHABILITATION

Provider Business Mailing Address
First Line	:	15615 PACIFIC ST
Second Line	:	SUITE 6
City	:	OMAHA
State	:	NE
Zip	:	68118-2118
Country	:	US
Telephone Number	:	913-575-2410
Fax Number	:

Provider Business Practice Location Address
First Line	:	15615 PACIFIC ST
Second Line	:	SUITE 6
City	:	OMAHA
State	:	NE
Zip	:	68118-2118
Country	:	US
Telephone Number	:	913-575-2410
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID JOHN EISENMENGER
Credential	:	D.C.
Telephone Number	:	913-575-2410

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	06/30/2011

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Directions to “PEAK PERFORMANCE CHIROPRACTIC & REHABILITATION ” Practice Location

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