Provider Demographics
NPI:1679973358
Name:PERFORMANCE THERAPIES PLUS LLC
Entity Type:Organization
Organization Name:PERFORMANCE THERAPIES PLUS LLC
Other - Org Name:THE ACUPUNCTURE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:480-641-5353
Mailing Address - Street 1:2855 E BROWN RD STE 20
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-4216
Mailing Address - Country:US
Mailing Address - Phone:480-641-5353
Mailing Address - Fax:
Practice Address - Street 1:2855 E BROWN RD STE 20
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-4216
Practice Address - Country:US
Practice Address - Phone:480-641-5353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0550261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center