Provider Demographics
NPI:1023045903
Name:PECK, ANTHONY KENNETH (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:KENNETH
Last Name:PECK
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:3775 BIRDIE CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2169 FIELD HOUSE DR
Practice Address - Street 2:
Practice Address - City:U S A F ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-9599
Practice Address - Country:US
Practice Address - Phone:719-333-0218
Practice Address - Fax:719-333-0204
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer