Provider Demographics
NPI:1588467831
Name:RULE 76 PERFORMANCE, LLC
Entity type:Organization
Organization Name:RULE 76 PERFORMANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ORTOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:203-500-6118
Mailing Address - Street 1:22 FRONT ST STE 210
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1705
Mailing Address - Country:US
Mailing Address - Phone:203-500-6118
Mailing Address - Fax:
Practice Address - Street 1:22 FRONT ST STE 210
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1705
Practice Address - Country:US
Practice Address - Phone:203-500-6118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy