| Organization Name: | PERFORMANCE THERAPY, LLC |
| NPI Number: | 1043520752 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC JOSEPH VAN HULLE (MEMBER / PARTNER) |
| Mailing Address: | 1457 N Rochester Rd Rochester Hills |
| State: | MI US |
| Postal Code: | 483071122 |
| Phone Number: | 2487594446 |
| Fax Number: | 2487594448 |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 04/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 5501010847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |