Healthcare Provider Details
I. General information
NPI: 1295521995
Provider Name (Legal Business Name): PEAK MOTION PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
135 DEPOT ST # 2A
MANCHESTER CENTER VT
05255-8605
US
IV. Provider business mailing address
PO BOX 804
MANCHESTER VT
05254-0804
US
V. Phone/Fax
- Phone: 802-319-9283
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ELIZABETH
MOULTON
Title or Position: BUSINESS OWNER
Credential: DPT
Phone: 207-256-7128