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General NPI Number Information
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NPI Number | 1346656816
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Entity Type | Organization
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Legal Business Name | PEAK PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 07/06/2014
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 1355 W WHITE MOUNTAIN BLVD SUITE B
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City | LAKESIDE
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State | AZ
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Zip | 85929-6395
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Country | US
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Telephone | 928-367-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 W WHITE MOUNTAIN BLVD SUITE B
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City | LAKESIDE
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State | AZ
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Zip | 85929-6395
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Country | US
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Telephone |
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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. DAVID L VALENTINE
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Credential | P.T., D.P.T.
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Telephone | 928-367-7325
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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 | 9997
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9996
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License Number State | AZ
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