Provider Demographics
NPI:1700812229
Name:PEAK PERFORMANCE PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:PEAK PERFORMANCE PHYSICAL THERAPY INC.
Other - Org Name:PEAK PERFORMANCE PHYSICAL THERAPY, PC DBA WESTSIDE PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-530-3065
Mailing Address - Street 1:2020 W COLORADO AVE STE C-305
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-3882
Mailing Address - Country:US
Mailing Address - Phone:719-249-1600
Mailing Address - Fax:719-249-1773
Practice Address - Street 1:2020 W COLORADO AVE STE C-305
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-3882
Practice Address - Country:US
Practice Address - Phone:719-249-1600
Practice Address - Fax:719-249-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801560Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER