Provider First Line Business Practice Location Address:
11504 W 135TH ST.
Provider Second Line Business Practice Location Address:
PERFORMANCE REHAB. LLC
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-681-9909
Provider Business Practice Location Address Fax Number:
913-681-9906
Provider Enumeration Date:
08/26/2010