Provider Demographics
NPI:1073399861
Name:ENDURE PERFORMANCE TRAINING LLC
Entity Type:Organization
Organization Name:ENDURE PERFORMANCE TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:VANNUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:602-686-0886
Mailing Address - Street 1:2823 S LYNCH
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-2185
Mailing Address - Country:US
Mailing Address - Phone:496-480-2599
Mailing Address - Fax:
Practice Address - Street 1:1551 E ELLIOT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-7002
Practice Address - Country:US
Practice Address - Phone:602-686-0886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty