Healthcare Provider Details

I. General information

NPI: 1275113573
Provider Name (Legal Business Name): ZENITH PERFORMANCE AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2021
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S PARK ST
EUGENE OR
97401-2931
US

IV. Provider business mailing address

160 S PARK ST
EUGENE OR
97401-2931
US

V. Phone/Fax

Practice location:
  • Phone: 952-237-9737
  • Fax: 458-201-4465
Mailing address:
  • Phone: 952-237-9737
  • Fax: 458-201-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JESSE KLEIN
Title or Position: OWNER/OPERATOR
Credential: DPT
Phone: 952-237-9737