| Organization Name: | PERFORMANCE REHAB, INC |
| NPI Number: | 1568455889 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUZANNE S WALTERS (PRESIDENT) |
| Mailing Address: | 7213 S Siwell Rd Byram |
| State: | MS US |
| Postal Code: | 392729776 |
| Phone Number: | 6013469191 |
| Fax Number: | 6013465011 |
| NPI Enumeration Date: | 08/23/2005 |
| NPI Last Update Date: | 05/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | 0524742 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |