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General NPI Number Information
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NPI Number | 1831614676
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Entity Type | Organization
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Legal Business Name | HIGH PEAK PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 08/12/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 13 BAYWOOD DR
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City | QUEENSBURY
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State | NY
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Zip | 12804
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Country | US
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Telephone | 518-761-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 13 BAYWOOD DR
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City | QUEENSBURY
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State | NY
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Zip | 12804-5822
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Country | US
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Telephone | 518-761-0850
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY JAMES MERRIGAN
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Credential | PT DPT
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Telephone | 518-307-1326
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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 | 037706
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License Number State | NY
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