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General NPI Number Information
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NPI Number | 1306592209
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Entity Type | Organization
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Legal Business Name | PEAK PHYSICAL THERAPY AND PERFORMANCE TRAINING LLC
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 4050 CANDLE LIGHT DR
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City | DAYTON
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State | MD
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Zip | 21036-1141
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Country | US
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Telephone | 201-873-8406
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 CANDLE LIGHT DR
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City | DAYTON
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State | MD
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Zip | 21036-1141
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Country | US
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Telephone | 201-873-8406
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTAN LEIGH FISH
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Credential | DPT
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Telephone | 201-873-8406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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