Provider Demographics
NPI:1750774022
Name:PEAK PERFORMANCE PHYSICAL THERAPY
Entity type:Organization
Organization Name:PEAK PERFORMANCE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASSAING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-295-8183
Mailing Address - Street 1:11320 INDUSTRIPLEX BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-4108
Mailing Address - Country:US
Mailing Address - Phone:225-295-8183
Mailing Address - Fax:225-295-8236
Practice Address - Street 1:11320 INDUSTRIPLEX BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-4108
Practice Address - Country:US
Practice Address - Phone:225-295-8183
Practice Address - Fax:225-295-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09031R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721315267OtherPHYSICAL THERAPY