Healthcare Provider Details
I. General information
NPI: 1073385217
Provider Name (Legal Business Name): PEAK PHYSIOTHERAPY AND SPORTS PERFORMANCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2023
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10620 MALTESE PT
PEYTON CO
80831-4752
US
IV. Provider business mailing address
PO BOX 363
PEYTON CO
80831-0363
US
V. Phone/Fax
- Phone: 719-401-1166
- Fax:
- Phone: 719-401-1166
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
FURLIN
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, OCS, CISSN
Phone: 719-401-1166