The Performance Center, Pllc

NPI #1336273317 in Ada, Oklahoma

Provider Information

NPI Number: 1336273317
Entity Type: Organization
Organization Name: The Performance Center, Pllc
Primary Specialty: Physical Therapist
Enumeration Date: Mar 14, 2007
Last Updated: Dec 30, 2008

Practice Location

Address: 511 N MONTE VISTA ST
City: Ada
State: Oklahoma
ZIP Code: 74820-4611
Phone: (580) 436-3633

Authorized Official

Name: DAN CHARBONEAU
Title: PHYSCIAL THERAPIST
Phone: (580) 436-3633

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X
Physical Therapist	225100000X	Primary

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