A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Rehabilitation |
111NR0400X | 35 | Chiropractic |
| NPI # | 1922145911 |
| LBN Legal business name | PERFORMANCE HEALTH MEDICAL GROUP |
| Authorized official | BRIAN CARRICO - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/31/2007 |
| Last updated | 04/22/2009 - About 17 years ago |
| Identifiers | n/a |
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PERFORMANCE HEALTH MEDICAL GROUP
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