# PERFORMANCE SPINE AND SPORTS CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386967099
- **Authorized official:** DR. WESLEY DAVID CREECH D.C. (CHIROPRACTOR)
- **Authorized official phone:** (731) 796-6910

## Contact information

- **Practice address:** 332 S 36TH ST, SUITE 3, QUINCY, IL 62301-5808
- **Practice address phone:** (731) 796-6910
- **Mailing address:** 535 JONES RD, UNION CITY, TN 38261-9023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 038011628 | IL | Yes |

## Other

- **Enumeration date:** 03/09/2010
- **Last updated:** 03/09/2010