Provider Demographics
NPI:1326346883
Name:PERFORMANCE SPINE & SPORTS PHYSICIANS P.C.
Entity Type:Organization
Organization Name:PERFORMANCE SPINE & SPORTS PHYSICIANS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-285-7013
Mailing Address - Street 1:2 LAWNTON RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1800
Mailing Address - Country:US
Mailing Address - Phone:610-285-7013
Mailing Address - Fax:
Practice Address - Street 1:2 LAWNTON RD
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1800
Practice Address - Country:US
Practice Address - Phone:610-285-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERFORMANCE SPINE & SPORTS PHYSICIANS P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty