| NPI | 1255746715 |
|---|---|
| Doing Business As | PERFORMANCE MEDICAL CLINIC LLC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS AMBROSE Owner/CEO 618-420-9360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2018-07-18 |