Healthcare Provider Details

I. General information

NPI: 1043859747
Provider Name (Legal Business Name): PEAK REHABILITATION OF DENVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 W 120TH AVE UNIT 900
WESTMINSTER CO
80234-3876
US

IV. Provider business mailing address

16522 KEYSTONE BLVD STE N
PARKER CO
80134-3302
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-2146
  • Fax: 303-840-7326
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS DE MARCO
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 575-313-3809