| Performance Physical Therapy & Sports Medicine Inc | |
|
106 Pearl Dr, Suite 104, La Fayette, GA 30728-7509 | |
| (706) 638-3880 | |
| (706) 638-3890 |
| Full Name | Performance Physical Therapy & Sports Medicine Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 106 Pearl Dr, La Fayette, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871738872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Lara E Betz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205832599 PECOS PAC ID: 1456371533 Enrollment ID: I20051205000313 |
| Provider Name | Jeffrey B Giddens |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578569794 PECOS PAC ID: 2860412764 Enrollment ID: I20051206000616 |
| Provider Name | Christina L Broome |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730333550 PECOS PAC ID: 9335200997 Enrollment ID: I20081202000325 |
| Provider Name | Matthew Samuel Gregory |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356637623 PECOS PAC ID: 1951579242 Enrollment ID: I20110712000129 |
| Provider Name | George Reed |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770530172 PECOS PAC ID: 4082645593 Enrollment ID: I20110801000041 |
| Provider Name | June Elaine Hanks |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689829194 PECOS PAC ID: 9537477559 Enrollment ID: I20150924001609 |
| Provider Name | Jensen Hackett Wages |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538517966 PECOS PAC ID: 8022302926 Enrollment ID: I20160815002046 |
| Provider Name | Laura C Durel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093761736 PECOS PAC ID: 6709813298 Enrollment ID: I20200818002301 |
| Provider Name | Carly Renee Penhollow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265803142 PECOS PAC ID: 8527486737 Enrollment ID: I20200918001690 |
| Provider Name | Holli Guthrie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457920167 PECOS PAC ID: 3375946056 Enrollment ID: I20210720000964 |
| Provider Name | Larken Logan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518534601 PECOS PAC ID: 8820491319 Enrollment ID: I20210721001493 |
| Provider Name | Brooklynn Frazier Wood |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659079945 PECOS PAC ID: 7416314356 Enrollment ID: I20230607002537 |
| Provider Name | Taylor Peters |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194417295 PECOS PAC ID: 6406214279 Enrollment ID: I20230627000688 |
| Provider Name | Ashley Elizabeth Collins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336357961 PECOS PAC ID: 3577913326 Enrollment ID: I20231220001980 |
| Provider Name | Alexandra Chandler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184479537 PECOS PAC ID: 7911440805 Enrollment ID: I20240620000614 |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Physical Therapy & Sports Medicine Inc Po Box 528, Rome, GA 30162-0528 Ph: (706) 638-3880 | Performance Physical Therapy & Sports Medicine Inc 106 Pearl Dr, Suite 104, La Fayette, GA 30728-7509 Ph: (706) 638-3880 |
Ms. Latefa Nichelle Terry, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 120 W Villanow St, La Fayette, GA 30728 Phone: 706-638-5983 | |
Carter Grant, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 106 Pearl Dr Ste 104, La Fayette, GA 30728 Phone: 706-638-3880 Fax: 706-638-3890 | |
Courtney Durham, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 106 Pearl Dr Ste 104, La Fayette, GA 30728 Phone: 706-638-3880 | |
Matthew Parker, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 106 Pearl Dr Ste 104, La Fayette, GA 30728 Phone: 706-638-3880 Fax: 706-638-3890 | |
Mrs. Angela Leanne Tatum, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4147 Straight Gut Rd, La Fayette, GA 30728 Phone: 706-764-2951 Fax: 706-764-2951 | |
Lauren Taylor Shank, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 106 Pearl Dr, Suite 104, La Fayette, GA 30728 Phone: 706-638-3880 Fax: 706-638-3890 | |
Holli Guthrie, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 106 Pearl Dr Ste 104, La Fayette, GA 30728 Phone: 706-638-3880 Fax: 706-638-3890 |