Organization
PERFORMANCE PLUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA LYNN THELEN (OWNER)
(651) 429-9891
Entity
Organization
Contact information
Practice address
2543 7TH AVE E, SAINT PAUL, MN 55109-3004
(651) 429-9891
Mailing address
2543 7TH AVE E, SAINT PAUL, MN 55109-3004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1328
MN
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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