Peak Performance Chiropractic and Sports Rehabilitation Center LLC
Organization Active NPI Rehabilitation Chiropractor · Delta, UT
NPI 1194191817 · NPPES record last updated May 6, 2016
Key facts
- NPI
- 1194191817
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Chiropractor 111NR0400X
- License
- 94077161202 (UT)
- Legal business name
- PEAK PERFORMANCE CHIROPRACTIC AND SPORTS REHABILITATION CENTER LLC
- Practice address
- 60 S 300 E
Delta, UT 84624-5551 - Phone
- (435) 864-2000
- Fax
- (435) 864-2002
- NPI assigned
- Aug 17, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Jordan Karl Mecham, D.C.
- Title
- Owner
- Phone
- (435) 406-1414
Practitioners 1
-
Jordan Karl Mecham, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160516002201 | UT | Part B Supplier - Clinic/Group Practice | 2466769138 |
Receives reassigned benefits from 1 practitioner Practice locations: Delta, UT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor |
111NR0400X | 94077161202 | UT | Yes |
Addresses
Primary practice location
60 S 300 E
Delta, UT 84624-5551
Mailing address
230 S 400 W
Delta, UT 84624-9233
Phone (435) 864-2000
Other providers in Delta, UT
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- Cody Nielson
- Drew Nielson
- Spencer Gordon Nielson
- Glenys E Parkinson
- Taylor L Petersen
- Ryan Peterson
- Marlow Plumb
- Skyler Porter
- Katie Poulsen
All providers in Delta, UT · Rehabilitation Chiropractor in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.