Organization
PERFORMANCE REHAB, LLC
Active
Organization
PERFORMANCE REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BUCKINGHAM PT (ADMINISTRATOR)
(913) 681-9909
Entity
Organization
Contact information
Practice address
11504 WEST 135TH STREET, OVERLAND PARK, KS 66221-3760
(913) 681-9909
(913) 681-9906
Mailing address
11504 WEST 135TH STREET, OVERLAND PARK, KS 66221-3760
(913) 681-9909
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37188012
BCBS
—
01
—
5712220
FIRST HEALTH
KS
01
—
762124
HEALTH LINK
KS
01
—
7907868
AETNA
KS
Enumeration date
07/12/2006
Last updated
12/30/2013
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