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General NPI Number Information
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NPI Number | 1528176419
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Entity Type | Organization
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Legal Business Name | PERFORMANCE PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 25864 BUSINESS CENTER DR STE C
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City | REDLANDS
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State | CA
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Zip | 92374-4515
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Country | US
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Telephone | 909-796-7700
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Fax | 909-796-4384
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | REDLANDS
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State | CA
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Zip | 92373-0261
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Country | US
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Telephone | 909-796-7700
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Fax | 909-796-4384
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER CHRISTOPHER LINGAS
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Credential | DPT, OCS, SCS
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Telephone | 909-796-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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