MEDICARE: PEAK PERFORMANCE PHYSICAL THERAPY PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	225100000X	Physical Therapist
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871581058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK PERFORMANCE PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	1940 HARVE AVE
Second Line	:	STE 2
City	:	MISSOULA
State	:	MT
Zip	:	59801-8332
Country	:	US
Telephone Number	:	406-542-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1940 HARVE AVE
Second Line	:	STE2
City	:	MISSOULA
State	:	MT
Zip	:	59801-8332
Country	:	US
Telephone Number	:	406-542-0808
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JILL ANNE OLSON
Credential	:
Telephone Number	:	406-542-0808

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	02/11/2025

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Directions to “PEAK PERFORMANCE PHYSICAL THERAPY PC ” Practice Location

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