Provider Demographics
NPI:1417640244
Name:PEIGAN, TASHELLE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:TASHELLE
Middle Name:
Last Name:PEIGAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 173
Mailing Address - Street 2:
Mailing Address - City:FORT QU'APPELLE
Mailing Address - State:SASKATCHEWAN
Mailing Address - Zip Code:S0G 1S0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:267 S CHURTON ST
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2695
Practice Address - Country:US
Practice Address - Phone:919-684-2445
Practice Address - Fax:919-643-4528
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist