# PROACTIVE PHYSICAL THERAPY AND SPORTS PERFORMANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083455638
- **Authorized official:** CLINTON ERIC SINGLETON DPT (OWNER, DOCTOR OF PHYSICAL THERAPY)
- **Authorized official phone:** (660) 973-7364

## Contact information

- **Practice address:** 623 S WASHINGTON STREET, CHILLICOTHE, MO 64601
- **Practice address phone:** (660) 973-7364
- **Mailing address:** 623 SOUTH WASHINGTON STREET, PO BOX 115, CHILLICOTHE, MO 64601
- **Mailing address phone:** (660) 973-7364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/05/2024
- **Last updated:** 06/05/2024