# PERFORMANCE SPORTSPHYSIO, LLC

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

## Provider details

- **NPI number:** 1538925938
- **Authorized official:** TOMOKI KEN USUI PT, DPT (OWNER)
- **Authorized official phone:** (720) 548-0068

## Contact information

- **Practice address:** 1325 DRY CREEK DR STE 307, LONGMONT, CO 80503-7751
- **Practice address phone:** (720) 548-0068
- **Mailing address:** 16321 GRAHAM PEAK WAY, BROOMFIELD, CO 80023-8326
- **Mailing address phone:** (720) 548-0068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2024
- **Last updated:** 02/28/2024