Provider Demographics
NPI:1982344578
Name:PERFORMANCE STRENGTH CHIROPRACTIC & PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:PERFORMANCE STRENGTH CHIROPRACTIC & PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PEETS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-849-6363
Mailing Address - Street 1:77A ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8881
Mailing Address - Country:US
Mailing Address - Phone:631-849-6363
Mailing Address - Fax:631-849-6361
Practice Address - Street 1:77A ROUTE 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8881
Practice Address - Country:US
Practice Address - Phone:631-849-6363
Practice Address - Fax:631-849-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty