Healthcare Provider Details

I. General information

NPI: 1447263686
Provider Name (Legal Business Name): PEAK PERFORMANCE THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W. COLORADO AVE UNIT 2B
TELLURIDE CO
81435-3178
US

IV. Provider business mailing address

PO BOX 3178
TELLURIDE CO
81435-3178
US

V. Phone/Fax

Practice location:
  • Phone: 970-728-1888
  • Fax: 970-369-4671
Mailing address:
  • Phone: 970-728-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK R CAMPBELL
Title or Position: PRESIDENT/OWNER
Credential: MSPT OCS CMPT
Phone: 970-728-1888