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Organization
PEAK PERFORMANCE PHYSICAL THERAPY AND FITNESS
Active
Organization
PEAK PERFORMANCE PHYSICAL THERAPY AND FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY EDWARD WADE PT (OWNER)
(435) 654-3719
Entity
Organization
Contact information
Practice address
23 SOUTH MAIN STREET, COALVILLE, UT 84017
(435) 654-3719
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(888) 700-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5327836-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529791445001
—
UT
Enumeration date
01/03/2007
Last updated
11/14/2007
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