PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC (NPI# 1487745477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487745477 |
| Entity Type | Organization |
| Organization Name | PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC |
| Other Organization Name | PERFORMANCE CHIROPRACTIC AND SOFT TISSUE CLINIC |
| Practice Address |
104 Ne 3rd St Suite 220 Grand Rapids MN 55744 |
| Practice Telephone | 2183260604 |
| Practice Fax Number | 2183261509 |
| Mailing Telephone | 2183260604 |
| Mailing Fax Number | 2183261509 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-10-31 |
| Authorized Official Name | MR. ADAM ZACHMAN (OWNER) |
| Authorized Official Telephone | 2183260604 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 4472 | MN | Chiropractic Providers |
| Y | 111N00000X | Chiropractor | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 120187500 | 05 |
| Other Name | Type Code |
|---|---|
| Performance Chiropractic and Soft Tissue Clinic | Former Legal Business Name - Organization |
| Street Address |
104 NE 3RD ST SUITE 220 |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821361163 | Adam Mark Zachman | Chiropractor | 104 Ne 3rd St, Ste 220, Grand Rapids, MN 55744-2869 | 2012-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114532835 | Pro-active Chiropractic Wellness of Grand Rapids | Chiropractor | 4270 Plainfield Ave Ne # E, Grand Rapids, MI 49525-1603 | 2020-09-10 |
| 1942823695 | Seth Andrew Leali | Chiropractor | 610 Maryland Ave Ne Ste B, Grand Rapids, MI 49505-6052 | 2020-05-28 |
| 1043833213 | Christopher Carl Netley | Chiropractor | 2020 Raybrook St Se Ste 204-d, Grand Rapids, MI 49546-7717 | 2020-05-22 |
| 1477185312 | 100 Percent Chiropractic Santos, LLC | Chiropractor | 2321 E Beltline Ave Ne Ste D, Grand Rapids, MI 49525-9803 | 2020-02-09 |
| 1164087052 | Zachary David Nelson | Chiropractor | 11279 Tallmadge Woods Dr Nw, Grand Rapids, MI 49534-6318 | 2019-05-06 |
| 1760959084 | Charles Justin Austin | Chiropractor | 2504 Ardmore St Se, Grand Rapids, MI 49506-4901 | 2018-10-24 |
| 1568959211 | Northside Chiropractic LLC | Chiropractor | 2221 Plainfield Ave Ne Ste 109, Grand Rapids, MI 49505-4215 | 2018-04-18 |
| 1831694983 | Connor Wade Knapp | Chiropractor | 6807 Cascade Rd Se Ste D, Grand Rapids, MI 49546-8722 | 2018-03-29 |
| 1528587524 | Melissa Thomas | Chiropractor | 4150 E Beltline Ave Ne Ste 3, Grand Rapids, MI 49525-9316 | 2017-09-12 |
| 1619497336 | Safina Ngandu | Chiropractor | 2180 44th St Se Ste 209, Grand Rapids, MI 49508-5305 | 2017-06-23 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.