Healthcare Provider Details
I. General information
NPI: 1447389259
Provider Name (Legal Business Name): PERFORMANCE ORTHOPEDIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
955 HOSFORD RD
GALION OH
44833-9325
US
IV. Provider business mailing address
PO BOX 704
GALION OH
44833-0704
US
V. Phone/Fax
- Phone: 419-468-7059
- Fax:
- Phone: 419-468-7059
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 35058529 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 34006810 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 35082136 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 4543 |
| License Number State | OH |
VIII. Authorized Official
Name:
JAMES
R
KERBS
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 419-468-7059