Provider Demographics
NPI:1891380937
Name:PEAK SLEEP WELLNESS LLC
Entity Type:Organization
Organization Name:PEAK SLEEP WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-757-8749
Mailing Address - Street 1:594 S 380 W
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-8503
Mailing Address - Country:US
Mailing Address - Phone:435-757-8749
Mailing Address - Fax:
Practice Address - Street 1:981 S MAIN ST STE 260
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-6083
Practice Address - Country:US
Practice Address - Phone:435-757-8749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty