Healthcare Provider Details

I. General information

NPI: 1376369678
Provider Name (Legal Business Name): FLASHPOINT PERFORMANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WOODRUFF INDUSTRIAL LN
GREENVILLE SC
29607-4101
US

IV. Provider business mailing address

112 WAKELON DR
GREER SC
29651-1984
US

V. Phone/Fax

Practice location:
  • Phone: 864-735-0593
  • Fax:
Mailing address:
  • Phone: 864-735-0593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW P HANNAN
Title or Position: CO FOUNDER
Credential: DPT
Phone: 864-735-0593