Provider Demographics
NPI:1891281101
Name:PERFORMANCE CARE CORPORATION
Entity Type:Organization
Organization Name:PERFORMANCE CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-477-6174
Mailing Address - Street 1:5551 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3101
Mailing Address - Country:US
Mailing Address - Phone:703-477-6174
Mailing Address - Fax:
Practice Address - Street 1:7343 ATLAS WALK WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-2992
Practice Address - Country:US
Practice Address - Phone:703-477-6174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty