Organization
PERFORMA PHYSICAL MEDICINE AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER LAURENCE CASTRO MD (PHYSICIAN)
(303) 845-2392
Entity
Organization
Contact information
Practice address
6435 S FM 549 STE 102, ROCKWALL, TX 75032-6221
(303) 845-2392
Mailing address
1244 HIGHLAND PL, ERIE, CO 80516-7918
(303) 845-2382
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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