Provider Demographics
NPI:1295423523
Name:PEAK PRECISION PLLC
Entity type:Organization
Organization Name:PEAK PRECISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT/OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:602-935-6486
Mailing Address - Street 1:1002 E INGRAM ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2654
Mailing Address - Country:US
Mailing Address - Phone:602-935-6486
Mailing Address - Fax:
Practice Address - Street 1:1002 E INGRAM ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2654
Practice Address - Country:US
Practice Address - Phone:602-935-6486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service