Organization
PERFORMANCE PROSTHETICS & ORTHOTICS, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT DAVID COOPER (OFFICE MANAGER)
(850) 607-6126
Entity
Organization
Contact information
Practice address
753 ASHLEY DR, CRESTVIEW, FL 32536-9231
(850) 331-3664
(850) 607-6674
Mailing address
3010 N 12TH AVE, PENSACOLA, FL 32503-4067
(850) 607-6126
(850) 607-6674
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
09/24/2020
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