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General NPI Number Information
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NPI Number | 1992803894
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Entity Type | Organization
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Legal Business Name | PEAK PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 108 E MAIN ST STE B
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City | WOODVILLE
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State | OH
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Zip | 43469-1209
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Country | US
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Telephone | 419-849-2900
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Fax | 419-849-2901
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Provider Business Mailing Address
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Address Line | 108 E MAIN ST STE B
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City | WOODVILLE
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State | OH
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Zip | 43469-1209
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Country | US
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Telephone | 419-849-2900
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Fax | 419-849-2901
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | ALYSSA M LECURGO
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Credential |
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Telephone | 419-699-4189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT-05091
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License Number State | OH
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