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General NPI Number Information
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NPI Number | 1003007865
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Entity Type | Organization
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Legal Business Name | PEAK REHABCARE, LLC
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 101 N 7TH ST # 16
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City | MAYFIELD
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State | KY
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Zip | 42066-1801
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Country | US
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Telephone | 270-247-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N 7TH ST # 16
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City | MAYFIELD
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State | KY
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Zip | 42066-1801
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Country | US
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Telephone | 270-247-6668
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER N KIONGO
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Credential | MHS, MBA, OTR
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Telephone | 270-727-1023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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