Provider Demographics
NPI:1689257776
Name:COMMITTED PERFORMANCE LLC
Entity Type:Organization
Organization Name:COMMITTED PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHNITIA
Authorized Official - Middle Name:DYANNE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:205-317-8172
Mailing Address - Street 1:4100 RED ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:AL
Mailing Address - Zip Code:35127-3520
Mailing Address - Country:US
Mailing Address - Phone:205-317-8172
Mailing Address - Fax:
Practice Address - Street 1:4100 RED ROCK WAY
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:AL
Practice Address - Zip Code:35127-3520
Practice Address - Country:US
Practice Address - Phone:205-317-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649670621OtherNPI TYPE 1