Provider Demographics
NPI:1679467427
Name:PHYSICAL MEDICINE & PERFORMANCE
Entity type:Organization
Organization Name:PHYSICAL MEDICINE & PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-720-6287
Mailing Address - Street 1:1050 W ELM AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-2715
Mailing Address - Country:US
Mailing Address - Phone:541-667-3832
Mailing Address - Fax:541-314-4875
Practice Address - Street 1:1050 W ELM AVE STE 160
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2715
Practice Address - Country:US
Practice Address - Phone:541-667-3832
Practice Address - Fax:541-314-4875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty