Provider Demographics
NPI:1669909693
Name:PEAK REHABILITATION, FITNESS AND PERFORMANCE CENTER LLC
Entity type:Organization
Organization Name:PEAK REHABILITATION, FITNESS AND PERFORMANCE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE & CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-273-4607
Mailing Address - Street 1:1305 DANTIGNAC ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2774
Mailing Address - Country:US
Mailing Address - Phone:706-922-6561
Mailing Address - Fax:706-823-3810
Practice Address - Street 1:550 SILVER BLUFF RD STE 600
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6038
Practice Address - Country:US
Practice Address - Phone:803-220-3655
Practice Address - Fax:803-226-0045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAK REHABILTATION, FITNESS AND PERFORMANCE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-22
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty