| NPI | 1679352884 |
|---|---|
| Former Legal Business Name | THE PERFORMANCE LAB LLC |
| Entity Type | Organization |
| Authorized Contact | REBECCA LAVAWAY CEO/Owner 475-233-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2023-09-26 |
| Last Update Date | 2023-09-26 |