Provider Demographics
NPI:1427605146
Name:PEAK ENDURANCE
Entity Type:Organization
Organization Name:PEAK ENDURANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:AGNEW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:608-218-4215
Mailing Address - Street 1:501 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-1403
Mailing Address - Country:US
Mailing Address - Phone:920-723-3251
Mailing Address - Fax:
Practice Address - Street 1:15 N BUTLER ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4237
Practice Address - Country:US
Practice Address - Phone:608-218-4215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy