Provider Demographics
NPI:1750168795
Name:VESSEL PERFORMANCE, LLC
Entity type:Organization
Organization Name:VESSEL PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, SCS, CSCS
Authorized Official - Phone:949-606-3240
Mailing Address - Street 1:4100 HIGHLAND AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3030
Mailing Address - Country:US
Mailing Address - Phone:949-606-3240
Mailing Address - Fax:
Practice Address - Street 1:2009 1/2 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-1931
Practice Address - Country:US
Practice Address - Phone:404-769-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy