Organization
PEAK PERFORMANCE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMYNE Y MCENTIRE (OWNER/ADMINISTRATOR)
(843) 463-9448
Entity
Organization
Contact information
Practice address
819 SEIGLE AVE APT 105, CHARLOTTE, NC 28204-2094
(843) 463-9948
Mailing address
819 SEIGLE AVE APT 105, CHARLOTTE, NC 28204-2094
(843) 463-9948
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
12/14/2021
Last updated
12/16/2021
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