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General NPI Number Information
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NPI Number | 1003607664
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Entity Type | Organization
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Legal Business Name | PEAK PERFORMANCE AND AESTHETICS LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 7535 E HAMPDEN AVE STE 400
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City | DENVER
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State | CO
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Zip | 80231-4844
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Country | US
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Telephone | 720-466-1711
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Fax | 720-386-8347
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Provider Business Mailing Address
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Address Line | 7535 E HAMPDEN AVE STE 400
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City | DENVER
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State | CO
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Zip | 80231-4844
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Country | US
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Telephone | 720-466-1711
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Fax | 720-386-8347
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Authorized Official
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Title or Position | OWNER
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Name | NATHANAEL LACARIA
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Credential | FNP-BC
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Telephone | 720-466-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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