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NPI 1366565459

NPI 1366565459 : ALLISON LEIGH PEEK : DALTON, GA

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General NPI Number Information
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    NPI Number           |    1366565459
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON LEIGH PEEK
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/06/2007
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    Last Update Date     |    02/22/2010
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Provider Practice Location Address
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    Address Line         |    1104 PROFESSIONAL BLVD 
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    City                 |    DALTON
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    State                |    GA
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    Zip                  |    30720-2588
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    Country              |    US
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    Telephone            |    706-266-5533
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    Fax                  |    706-529-5858
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Provider Business Mailing Address
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    Address Line         |    2216 KENWOOD DR 
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    City                 |    DALTON
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    State                |    GA
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    Zip                  |    30720-5788
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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    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    PTA 002184
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    License Number State |    GA
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