Provider Demographics
NPI:1881429702
Name:PEAK PERFORMANCE SPORTS AND FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:PEAK PERFORMANCE SPORTS AND FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FRANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-344-6662
Mailing Address - Street 1:6023 WEST RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506
Mailing Address - Country:US
Mailing Address - Phone:440-344-6662
Mailing Address - Fax:717-214-3009
Practice Address - Street 1:6023 WEST RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506
Practice Address - Country:US
Practice Address - Phone:440-344-6662
Practice Address - Fax:717-214-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty