| Organization Name: | PERFORMANCE VISION THERAPY, PLLC |
| NPI Number: | 1013305366 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY L KEGARISE (MBR) |
| Mailing Address: | 3252 Aspen Grove Dr 1 Franklin |
| State: | TN US |
| Postal Code: | 370674895 |
| Phone Number: | 6157717555 |
| Fax Number: | 6157717773 |
| NPI Enumeration Date: | 01/08/2015 |
| NPI Last Update Date: | 01/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |