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General NPI Number Information
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NPI Number | 1447496724
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Entity Type | Organization
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Legal Business Name | PEAKSIDE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 3845 SE LAKE WEIR AVE
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City | OCALA
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State | FL
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Zip | 34480-9153
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Country | US
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Telephone | 352-401-7610
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Fax | 352-438-0047
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Provider Business Mailing Address
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Address Line | 1010 SE 6TH PL
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City | OCALA
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State | FL
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Zip | 34471-3906
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Country | US
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Telephone | 352-401-7610
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Fax | 352-438-0047
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JANE A SAUER
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Credential | PT
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Telephone | 352-401-7610
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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 | PT18846
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License Number State | FL
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