Provider Demographics
NPI:1891805685
Name:PEAK PHYSICAL THERAPY, PLC
Entity Type:Organization
Organization Name:PEAK PHYSICAL THERAPY, PLC
Other - Org Name:PEAK PHYSICAL THERAPY & SPORTS REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIGGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:7575-647-3181
Mailing Address - Street 1:344 MCLAWS CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5648
Mailing Address - Country:US
Mailing Address - Phone:757-564-7381
Mailing Address - Fax:757-564-7391
Practice Address - Street 1:344 MCLAWS CIR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5648
Practice Address - Country:US
Practice Address - Phone:757-564-7381
Practice Address - Fax:757-564-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0105202326225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty