Performance Golf & Wellness Clinic

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

325159-2401 Issued in UT

Legal business name

PERFORMANCE GOLF & WELLNESS CLINIC

Practice address

1285 Gunn Ave
Salt Lake City, UT 84106-3039

Phone

(801) 746-8997

Fax

(801) 746-8996

NPI assigned

Jul 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Henry White, M.P.TNPI 1134153562

Title

Owner

Phone

(801) 746-8997

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Henry White, PT

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1134153562
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093731754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "888-700-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 GUNN AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063039",
            "telephone_number": "801-746-8997",
            "fax_number": "801-746-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE GOLF & WELLNESS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-746-8997",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "325159-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Perez
• Sara Perez
• Sara Perez
• Valerie K Perez
• Xiomara Perez
• Melyssa L Perkes, SSW
• Nathan Alma Perkes
• Annie Perkins
• Brooklyn E Perkins
• Dennis Dewayne Perkins, LCSW

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.