Provider Demographics
NPI:1689983876
Name:PERFORMANCE ORTHOPEDIC ASSOCIATES
Entity Type:Organization
Organization Name:PERFORMANCE ORTHOPEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-907-5333
Mailing Address - Street 1:200 OFFICE PARK DR STE 340
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2475
Mailing Address - Country:US
Mailing Address - Phone:205-423-0910
Mailing Address - Fax:
Practice Address - Street 1:200 OFFICE PARK DR STE 340
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2475
Practice Address - Country:US
Practice Address - Phone:205-423-0910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment