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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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