Healthcare Provider Details

I. General information

NPI: 1639949902
Provider Name (Legal Business Name): PEAK REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 WESTGATE DR STE B14C
DURHAM NC
27707-2696
US

IV. Provider business mailing address

1031 BELLENDEN DR
DURHAM NC
27713-9283
US

V. Phone/Fax

Practice location:
  • Phone: 984-833-2535
  • Fax: 919-313-4363
Mailing address:
  • Phone: 919-943-9449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MOLLIE ELIZABETH PATHMAN
Title or Position: PHYSICAL THERAPIST / OWNER
Credential: PT, DPT
Phone: 919-943-9449