Organization
PERFORMANCE PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH B SOUTHERLAND PT (OWNER)
(870) 270-7954
Entity
Organization
Contact information
Practice address
806 CALVERT RD, FORREST CITY, AR 72335-1914
(870) 270-5117
Mailing address
806 CALVERT RD, FORREST CITY, AR 72335-1914
(870) 270-5117
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182060742
—
AR
Enumeration date
07/26/2010
Last updated
07/26/2010
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