MEDICARE: PEAK PHYSICAL 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
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1477368512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	12652 TIMBERLAND BLVD STE 110
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5528
Country	:	US
Telephone Number	:	817-973-6991
Fax Number	:	817-973-6992

Authorized Official
Title or Position	:	CFO
Name	:	PREET TAKKAR
Credential	:
Telephone Number	:	408-914-8737

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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Directions to “PEAK PHYSICAL THERAPY, LLC ” Practice Location

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