# PHYSIOLETE THERAPY AND PERFORMANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHYSIOLETE THERAPY AND PERFORMANCE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669381885
- **Legal business name:** PHYSIOLETE THERAPY AND PERFORMANCE LLC
- **Authorized official:** LAUREN C BUCKALEW DPT (CO-OWNER)
- **Authorized official phone:** (769) 208-3190

## Contact information

- **Practice address:** 2625 COURTHOUSE CIR, FLOWOOD, MS 39232-9521
- **Practice address phone:** (769) 208-3190
- **Practice address fax:** (769) 208-3191
- **Mailing address:** PO BOX 2862, TUSCALOOSA, AL 35403-2862
- **Mailing address phone:** (205) 409-8060
- **Mailing address fax:** (205) 737-8841

## Taxonomy

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

## Other

- **Enumeration date:** 09/03/2026
- **Last updated:** 09/03/2026