Healthcare Provider Details
I. General information
NPI: 1053914846
Provider Name (Legal Business Name): PEAK MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2020
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3578 HARTSEL DR # E-328
COLORADO SPRINGS CO
80920-2103
US
IV. Provider business mailing address
PO BOX 673
MONUMENT CO
80132-0673
US
V. Phone/Fax
- Phone: 719-733-3086
- Fax:
- Phone: 719-733-3086
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANKLIN
BOSKOVICH
Title or Position: AUTHORIZED OFFICIAL
Credential: NP-C
Phone: 719-733-3086