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General NPI Number Information
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NPI Number | 1679460174
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Entity Type | Organization
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Legal Business Name | PRIME PERFORMANCE PT LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 3400 KASHIWA ST
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City | TORRANCE
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State | CA
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Zip | 90505-4025
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Country | US
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Telephone | 915-691-0427
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Fax |
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Provider Business Mailing Address
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Address Line | 7737 OAK LANDING DR
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City | EL PASO
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State | TX
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Zip | 79912-1336
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Country | US
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Telephone | 915-691-0427
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | ABIGAIL DEAN
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Credential | PT, DPT,
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Telephone | 915-691-0427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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