Organization
PEDIATRIC PERFORMANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARETHA J DE BRUIJN OTR/L (DIRECTOR)
(919) 942-8229
Entity
Organization
Contact information
Practice address
2012 LINK RD, CHAPEL HILL, NC 27516-8736
(919) 942-8229
(919) 942-8229
Mailing address
2012 LINK RD, CHAPEL HILL, NC 27516-8736
(919) 942-8229
(919) 942-8229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28053
BLUE CROSS PROVIDER
NC
Enumeration date
03/06/2009
Last updated
03/06/2009
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