Performance Builders, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501001249 Issued in MI

Legal business name

PERFORMANCE BUILDERS, LLC

Practice address

316 Stickney Ridge Rd
Grand Haven, MI 49417-9314

Phone

(616) 847-2115

NPI assigned

Nov 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert N Wiersma, PT

Title

President

Phone

(616) 847-2115

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1275714909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 STICKNEY RIDGE RD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179314",
            "telephone_number": "616-847-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 STICKNEY RIDGE RD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494179314",
            "telephone_number": "616-847-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE BUILDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "WIERSMA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-847-2115",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501001249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Jean Pebbles, PA-C
• Jessica Peerbolte
• Colin William Pellegrom, DDS
• Antoinette Victoria Pelot, PA-C
• Kelly Perez, PAC
• Peter D. Rick, DDS, PC
• Peter Rick Jr DDS PLLC
• Ashley Peterson
• Erica L Phelps, RD
• Physicians Dialysis Acquisitions Inc

• Physical Therapist in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.