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General NPI Number Information
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NPI Number | 1801025861
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Entity Type | Organization
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Legal Business Name | PEAK SPINE LLC
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 7304 S ALTON WAY SUITE A
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City | CENTENNIAL
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State | CO
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Zip | 80112-2314
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Country | US
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Telephone | 303-779-0830
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Fax |
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Provider Business Mailing Address
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Address Line | 7304 S ALTON WAY SUITE A
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City | CENTENNIAL
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State | CO
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Zip | 80112-2314
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Country | US
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Telephone | 303-779-0830
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. FRANK WESLEY WAINRIGHT
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Credential |
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Telephone | 303-779-0830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | CO
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