# PERFORMANCE PHYSICAL THERAPY, INC.

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

## Provider details

- **NPI number:** 1528258811
- **Authorized official:** CHARLENE REECE (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (662) 728-7218

## Contact information

- **Practice address:** 809 N 2ND ST, BOONEVILLE, MS 38829
- **Practice address phone:** (662) 728-7218
- **Practice address fax:** (662) 728-7228
- **Mailing address:** 809 N 2ND ST, BOONEVILLE, MS 38829-1309
- **Mailing address phone:** (662) 728-7218
- **Mailing address fax:** (662) 728-7228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT2339 | NULL | Yes |
| 225100000X | Physical Therapist | PT2339 | — | Yes |

## Other

- **Enumeration date:** 08/01/2007
- **Last updated:** 08/22/2018