# PERSONAL PERFORMANCE MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PERSONAL PERFORMANCE MEDICAL CORPORATION
- **Other names:** Fit-Well Prosthetic and Orthotic Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114154622
- **Legal business name:** PERSONAL PERFORMANCE MEDICAL CORPORATION
- **Authorized official:** MR. SCOTT E ALLEN CERTIFIED PROSTHETIS (OWNER)
- **Authorized official phone:** (801) 364-3100

## Contact information

- **Practice address:** 3354 HARRISON BLVD, SUITE 3, OGDEN, UT 84403-1296
- **Practice address phone:** (801) 334-6000
- **Practice address fax:** (801) 317-4019
- **Mailing address:** 7575 S 900 E, MIDVALE, UT 84047-2343
- **Mailing address phone:** (801) 364-3100
- **Mailing address fax:** (801) 872-5714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 06/11/2009
- **Last updated:** 07/05/2024