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Organization

PERFORMANCE CHIROPRACTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY JAMES BELLEAU BS, DC, CCSP, CKTP (DOCTOR)
(920) 406-8700
Entity
Organization

Contact information

Practice address
825 S HURON RD STE H, GREEN BAY, WI 54311-8029
(920) 406-8700
(920) 406-8712
Mailing address
825 S HURON RD STE H, GREEN BAY, WI 54311-8029
(920) 406-8700
(920) 406-8712

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2670-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38868000
WI
Enumeration date
01/19/2007
Last updated
08/22/2020
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