Provider Demographics
NPI:1285039982
Name:ADVANCED PERFORMANCE, PLLC
Entity Type:Organization
Organization Name:ADVANCED PERFORMANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:MARSTON
Authorized Official - Last Name:ALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:662-843-8712
Mailing Address - Street 1:110 E END ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2742
Mailing Address - Country:US
Mailing Address - Phone:662-843-8712
Mailing Address - Fax:662-843-0364
Practice Address - Street 1:110 E END ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2742
Practice Address - Country:US
Practice Address - Phone:662-843-8712
Practice Address - Fax:662-843-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty