MEDICARE: PEAK REHAB LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225200000X	Physical Therapy Assistant
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1629831219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK REHAB LLC

Provider Business Mailing Address
First Line	:	7376 GLEN EAGLE DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9316
Country	:	US
Telephone Number	:	989-992-1367
Fax Number	:

Provider Business Practice Location Address
First Line	:	7376 GLEN EAGLE DR
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9316
Country	:	US
Telephone Number	:	989-992-1367
Fax Number	:

Authorized Official
Title or Position	:	PT
Name	:	MR. JEFF ADAM NIEVIEROWSKI
Credential	:	PT
Telephone Number	:	989-992-1367

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/29/2024

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Directions to “PEAK REHAB LLC ” Practice Location

Language	Start Address	Practice Location

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