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General NPI Number Information
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NPI Number | 1881034692
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Entity Type | Organization
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Legal Business Name | PERFORMA REHAB SERVICES, LLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 638 E MAIN ST.
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City | MELBOURNE
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State | AR
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Zip | 72556
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Country | US
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Telephone | 901-800-8512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | MELBOURNE
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State | AR
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Zip | 72556-0617
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Country | US
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Telephone | 870-368-3020
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Fax | 870-368-3025
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. CHRISTOPHER DAVID MONROE
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Credential |
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Telephone | 901-800-8512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | AR
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Taxonomy #3
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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 | AR
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