Provider Demographics
NPI:1225815715
Name:PERFORM BTY INC
Entity Type:Organization
Organization Name:PERFORM BTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIUKAUSKAITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-890-9031
Mailing Address - Street 1:410 SE 16TH CT APT 109
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2543
Mailing Address - Country:US
Mailing Address - Phone:630-890-9031
Mailing Address - Fax:
Practice Address - Street 1:410 SE 16TH CT APT 109
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2543
Practice Address - Country:US
Practice Address - Phone:630-890-9031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty