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Organization
PEAK PERFORMANCE THERAPY LLC
Active
Organization
PEAK PERFORMANCE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A KEENAN PT (OWNER)
(804) 758-5588
Entity
Organization
Contact information
Practice address
390 VIRGINIA ST, URBANNA, VA 23175
(804) 758-5588
(804) 758-5589
Mailing address
390 VIRGINIA ST, B, URBANNA, VA 23175
(804) 758-5588
(804) 758-5589
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305003508
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003011537
—
VA
01
—
364394
ANTHEM
VA
Enumeration date
06/15/2007
Last updated
08/14/2009
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