Provider Demographics
NPI:1851965172
Name:SUPERIOR PHYSIOTHERAPY & PERFORMANCE, LLC
Entity Type:Organization
Organization Name:SUPERIOR PHYSIOTHERAPY & PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:513-728-5389
Mailing Address - Street 1:3470 CARDIFF AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3470 CARDIFF AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1318
Practice Address - Country:US
Practice Address - Phone:513-728-5389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy