Organization
THE PERFORMANCE CENTER, PLLC
Active
Other names
The Performance Center of Ada
Organization subpart
No
Provider details
NPI number
Authorized official
DAN CHARBONEAU (PHYSCIAL THERAPIST)
(580) 436-3633
Entity
Organization
Contact information
Practice address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633
(580) 436-2977
Mailing address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633
(580) 436-2977
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2218
OK
261QP2000X
Physical Therapy Clinic/Center
2218
OK
Other
Enumeration date
03/14/2007
Last updated
12/30/2008
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