Provider Demographics
NPI:1578719761
Name:PERFORMANCE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:PERFORMANCE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-689-0935
Mailing Address - Street 1:1000 RIVER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3230
Mailing Address - Country:US
Mailing Address - Phone:541-689-0935
Mailing Address - Fax:541-461-6884
Practice Address - Street 1:1000 RIVER RD
Practice Address - Street 2:SUITE B
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3230
Practice Address - Country:US
Practice Address - Phone:541-689-0935
Practice Address - Fax:541-461-6884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy