# PERFORMANCE SPINE & SPORTS SPECIALISTS, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1477982833
- **Authorized official:** MRS. GAIL REVIS (OFFICE MANAGER)
- **Authorized official phone:** (336) 501-3796

## Contact information

- **Practice address:** 1507 WESTOVER TER, SUITE B, GREENSBORO, NC 27408-7130
- **Practice address phone:** (336) 501-3796
- **Practice address fax:** (336) 333-5477
- **Mailing address:** 1507 WESTOVER TER, SUITE B, GREENSBORO, NC 27408-7130
- **Mailing address phone:** (336) 501-3796
- **Mailing address fax:** (336) 333-5477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 2007-00213 | NC | Yes |

## Other

- **Enumeration date:** 11/06/2013
- **Last updated:** 11/10/2014