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General NPI Number Information
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NPI Number | 1215623152
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Entity Type | Organization
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Legal Business Name | PERFORMANCE AUTO
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 825 S POST RD
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City | SHELBY
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State | NC
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Zip | 28152-6932
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Country | US
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Telephone | 704-781-7502
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Fax |
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Provider Business Mailing Address
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Address Line | 502 MILLSAP RD
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City | SHELBY
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State | NC
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Zip | 28150-9635
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Country | US
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Telephone | 704-751-8000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL LEE FEASTER
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Credential |
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Telephone | 704-751-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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