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NPI Code Detail

MEDICARE: PEAK PEDIATRIC THERAPY, LLC

MEDICARE: PEAK PEDIATRIC THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist
2235Z00000XSpeech-Language Pathologist
3261QP2000XPhysical Therapy Clinic/Center
4261QX0100XOccupational Medicine Clinic/Center
52251P0200XPediatric Physical Therapist

General Provider Information

NPI Number : 1366212268
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEAK PEDIATRIC THERAPY, LLC
Provider Business Mailing Address
First Line : 36 PEMBERTON CV
Second Line :
City : JACKSON
State : TN
Zip : 38305-5514
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7135 CHARLOTTE PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37209-5017
Country : US
Telephone Number : 731-394-1145
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : CHARLES JERMAN
Credential :
Telephone Number : 731-234-8120
Provider Enumeration Date : 01/03/2024
Last Update Date : 01/03/2024

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Directions to “PEAK PEDIATRIC THERAPY, LLC ” Practice Location

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