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Organization

PERFORMANCE MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KANISHA HALL MD (OWNER)
(202) 709-9822
Entity
Organization

Contact information

Practice address
110 W VINE ST, LEXINGTON, KY 40507-1658
(859) 208-6781
(859) 208-6803
Mailing address
3050 POST OAK BLVD STE 510, HOUSTON, TX 77056-6512
(866) 943-2384
(713) 885-9572

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
261QM2500X
Medical Specialty Clinic/Center

Other

Enumeration date
10/27/2017
Last updated
03/20/2023
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