Provider Demographics
NPI:1811215262
Name:PEAK PERFORMANCE PHYSICAL THERAPY & SPORTS TRAINING, LLC
Entity Type:Organization
Organization Name:PEAK PERFORMANCE PHYSICAL THERAPY & SPORTS TRAINING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CSCS
Authorized Official - Phone:303-870-8242
Mailing Address - Street 1:3750 DACORO LN
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-2501
Mailing Address - Country:US
Mailing Address - Phone:303-870-8242
Mailing Address - Fax:303-997-2145
Practice Address - Street 1:3750 DACORO LN
Practice Address - Street 2:SUITE 130
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-2501
Practice Address - Country:US
Practice Address - Phone:303-870-8242
Practice Address - Fax:303-997-2145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO317555Medicare UPIN