Provider Demographics
NPI:1053019570
Name:PEAK PERFORMANCE PHYSICAL THERAPY & SPORTS TRAINING, LLC
Entity type:Organization
Organization Name:PEAK PERFORMANCE PHYSICAL THERAPY & SPORTS TRAINING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:303-870-8242
Mailing Address - Street 1:3750 DACORO LN STE 130
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-2508
Mailing Address - Country:US
Mailing Address - Phone:303-870-8242
Mailing Address - Fax:
Practice Address - Street 1:12482 W KEN CARYL AVE UNIT A4
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3724
Practice Address - Country:US
Practice Address - Phone:303-870-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty