Healthcare Provider Details

I. General information

NPI: 1205900313
Provider Name (Legal Business Name): PEAK PERFORMANCE ORTHOPEDIC & SPORTS PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 N POINTE DR
WARSAW IN
46582-9042
US

IV. Provider business mailing address

169 N 200 E
COLUMBIA CITY IN
46725-8895
US

V. Phone/Fax

Practice location:
  • Phone: 574-267-3500
  • Fax: 574-267-3518
Mailing address:
  • Phone: 260-244-5133
  • Fax: 260-244-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number225100000X
License Number StateIN

VIII. Authorized Official

Name: SEAN THOMAS WHITE
Title or Position: PRESIDENT
Credential:
Phone: 260-244-5133