# PERFORMANCE SPINE & SPORTS PHYSICIANS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PERFORMANCE SPINE & SPORTS PHYSICIANS, P.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1770892937
- **Legal business name:** PERFORMANCE SPINE & SPORTS PHYSICIANS, P.C.
- **Authorized official:** LORI NELSON M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (610) 935-0719

## Contact information

- **Practice address:** 824 MAIN ST, SUITE 201, PHOENIXVILLE, PA 19460-4478
- **Practice address phone:** (610) 935-0719
- **Mailing address:** 824 MAIN ST, SUITE 201, PHOENIXVILLE, PA 19460-4478
- **Mailing address phone:** (610) 935-0719

## Taxonomy

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

## Other

- **Enumeration date:** 10/05/2010
- **Last updated:** 03/01/2011