Provider Demographics
NPI:1316022726
Name:PERFORMANCE ORTHOPEDICS PLLC
Entity Type:Organization
Organization Name:PERFORMANCE ORTHOPEDICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:GUETTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-988-8085
Mailing Address - Street 1:24255 W 13 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4320
Mailing Address - Country:US
Mailing Address - Phone:248-988-8085
Mailing Address - Fax:248-988-8565
Practice Address - Street 1:24255 W 13 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4320
Practice Address - Country:US
Practice Address - Phone:248-988-8085
Practice Address - Fax:248-988-8565
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERFORMANCE ORTHOPEDICS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
540F321700OtherGROUP DME BX
MI4398940001Medicare NSC