Organization
PERFORMANCE THERAPIES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARCY GARCIA (CFO)
(319) 665-2630
Entity
Organization
Contact information
Practice address
3290 RIDGEWAY DR, STE 3, CORALVILLE, IA 52241-2023
(319) 665-2605
(319) 665-2631
Mailing address
3290 RIDGEWAY DR, STE 3, CORALVILLE, IA 52241-2023
(319) 665-2605
(319) 665-2631
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0428987
—
IA
01
—
33506
WELLMARK BCBS
IA
01
—
DA5328
RAILROAD MEDICARE
IA
01
—
F232553
MIDLANDS CHOICE
IA
Enumeration date
07/10/2006
Last updated
04/18/2023
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