| NPI | 1336273317 |
|---|---|
| Other Name | THE PERFORMANCE CENTER OF ADA |
| Entity Type | Organization |
| Authorized Contact | DAN CHARBONEAU Physcial Therapist 580-436-3633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 2218) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: OK 2218) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-12-30 |