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Organization
PERFORMANCE PHYSIOTHERAPY, INC.
Active
Organization
PERFORMANCE PHYSIOTHERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK BRIDDELL PT (PRESIDENT)
(252) 367-1118
Entity
Organization
Contact information
Practice address
12137 ELM ST, PRINCESS ANNE, MD 21853-1358
(252) 367-1118
Mailing address
PO BOX 54, ZEBULON, NC 27597-0054
(919) 404-1448
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P11098
NC
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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