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Organization
PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC
Active
Organization
PERFORMANCE CHIROPRACTIC AND SPORTS CLINIC
Active
Other names
Performance Chiropractic and Soft Tissue Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM ZACHMAN DC (OWNER)
(218) 326-0604
Entity
Organization
Contact information
Practice address
104 NE 3RD ST, SUITE 220, GRAND RAPIDS, MN 55744
(218) 326-0604
(218) 326-1509
Mailing address
104 NE 3RD ST, SUITE 220, GRAND RAPIDS, MN 55744
(218) 326-0604
(218) 326-1509
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4472
MN
111N00000X
Chiropractor
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120187500
—
MN
Enumeration date
09/27/2006
Last updated
10/31/2013
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