Provider Demographics
NPI:1346374170
Name:HUMAN PERFORMANCE CENTER 5
Entity Type:Organization
Organization Name:HUMAN PERFORMANCE CENTER 5
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RINDERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:405-759-3773
Mailing Address - Street 1:1200 SW 104TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-3018
Mailing Address - Country:US
Mailing Address - Phone:405-759-3773
Mailing Address - Fax:405-759-3780
Practice Address - Street 1:1200 SW 104TH ST STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-3018
Practice Address - Country:US
Practice Address - Phone:405-759-3773
Practice Address - Fax:405-759-3780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty