# PERFORMANCE SPINE & SPORTS SPECIALISTS, PA

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

## Provider details

- **NPI number:** 1366761793
- **Authorized official:** DR. SHAWN DALTON-BETHEA M.D. (PRESIDENT)
- **Authorized official phone:** (336) 501-3796

## Contact information

- **Practice address:** 1507 WESTOVER TER STE B, SUITE A, GREENSBORO, NC 27408-7121
- **Practice address phone:** (336) 501-3796
- **Practice address fax:** (336) 333-5477
- **Mailing address:** PO BOX 38728, GREENSBORO, NC 27438-8728
- **Mailing address phone:** (336) 501-3796
- **Mailing address fax:** (336) 333-5477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/25/2010
- **Last updated:** 12/01/2014