Organization
PERFORMANCE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SHANE FOSTER MPT (OWNER/ PHYSICAL THERAPIST)
(918) 341-5355
Entity
Organization
Contact information
Practice address
13502 E 480 RD, CLAREMORE, OK 74017-3591
(918) 341-5355
Mailing address
13502 E 480 RD, CLAREMORE, OK 74017-3591
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/02/2006
Last updated
08/22/2020
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