| NPI | 1083069801 |
|---|---|
| Former Legal Business Name | PERFORMANCE CHIROPRACTIC & SPORTS MEDICINE PLLC |
| Entity Type | Organization |
| Authorized Contact | TICEE JOHNSON Credentialing 214-801-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2026-02-11 |