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General NPI Number Information
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NPI Number | 1720160963
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Entity Type | Organization
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Legal Business Name | PERFORMANCE ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 24255 W 13 MILE RD SUITE 100
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-4320
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Country | US
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Telephone | 248-988-8085
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Fax | 248-988-8565
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Provider Business Mailing Address
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Address Line | 24255 W 13 MILE RD SUITE 100
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-4320
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Country | US
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Telephone | 248-988-8085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH GUETTLER
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Credential | M.D
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Telephone | 248-988-8085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number |
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License Number State |
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