Healthcare Provider Details

I. General information

NPI: 1437647070
Provider Name (Legal Business Name): HEALTH PERFORMANCE SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 TOWNE DR STE 102
BLUFFTON SC
29910
US

IV. Provider business mailing address

55 HOSPITAL CENTER CMNS
HILTON HEAD ISLAND SC
29926-2837
US

V. Phone/Fax

Practice location:
  • Phone: 843-441-9208
  • Fax:
Mailing address:
  • Phone: 843-540-3587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL BAKER
Title or Position: CO-OWNER
Credential:
Phone: 843-540-3580