Healthcare Provider Details

I. General information

NPI: 1780732982
Provider Name (Legal Business Name): PEAKE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2007
Last Update Date: 09/02/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11350 MCCORMICK RD STE LL12
HUNT VALLEY MD
21031-1002
US

IV. Provider business mailing address

11350 EXECUTIVE PLAZA IV RD STE LL12
HUNT VALLEY MD
21031-8997
US

V. Phone/Fax

Practice location:
  • Phone: 410-527-1794
  • Fax: 410-527-9467
Mailing address:
  • Phone: 443-213-0395
  • Fax: 443-973-6125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number20197
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DEWALT DAVID BENDER
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 410-258-4721