| NPI | 1023511045 |
|---|---|
| Doing Business As | PERFORMANCE HEALTH MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | AMANDA GONZALEZ Ncpdp COO Rdinator 479-636-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA G45164) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |