Healthcare Provider Details

I. General information

NPI: 1912931437
Provider Name (Legal Business Name): PEAK PERFORMANCE PHYSICAL THERAPY AND FITNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/22/2020
Certification Date: 05/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11320 INDUSTRIPLEX BOULEVARD
BATON ROUGE LA
70809
US

IV. Provider business mailing address

11320 INDUSTRIPLEX BOULEVARD
BATON ROUGE LA
70809
US

V. Phone/Fax

Practice location:
  • Phone: 225-663-8239
  • Fax: 225-246-8730
Mailing address:
  • Phone: 225-663-8239
  • Fax: 225-246-8730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS PURVIS
Title or Position: ADMINISTRATOR/OWNER
Credential: PT, ATC
Phone: 225-663-8239