Provider Demographics
NPI:1710413018
Name:PEAK PT AND WELLNESS
Entity Type:Organization
Organization Name:PEAK PT AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CEPEDA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:954-549-3525
Mailing Address - Street 1:16522 KEYSTONE BLVD
Mailing Address - Street 2:UNIT N
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3303
Mailing Address - Country:US
Mailing Address - Phone:954-549-3525
Mailing Address - Fax:303-840-7326
Practice Address - Street 1:16522 KEYSTONE BLVD
Practice Address - Street 2:UNIT N
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3303
Practice Address - Country:US
Practice Address - Phone:954-549-3525
Practice Address - Fax:303-840-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005018261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy