Provider Demographics
NPI:1952175879
Name:INFINITE PERFORMANCE PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:INFINITE PERFORMANCE PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANAE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:916-670-0520
Mailing Address - Street 1:4101 INNOVATOR DR APT 1231
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3868
Mailing Address - Country:US
Mailing Address - Phone:916-670-0520
Mailing Address - Fax:
Practice Address - Street 1:4101 INNOVATOR DR APT 1231
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3868
Practice Address - Country:US
Practice Address - Phone:916-670-0520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty