Provider Demographics
NPI:1558772376
Name:SEVEN PERFORMANCE LLC
Entity Type:Organization
Organization Name:SEVEN PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:304-473-0531
Mailing Address - Street 1:108 3RD ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 3RD ST
Practice Address - Street 2:SUITE 8
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3831
Practice Address - Country:US
Practice Address - Phone:304-473-0531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 003214261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy