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Organization
SUMMIT PEAK PHYSICAL THERAPY PC
Active
Organization
SUMMIT PEAK PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON PAUL MOSES PT, DPT (PRESIDENT)
(817) 705-8558
Entity
Organization
Contact information
Practice address
2461 ROBINSON RD, GRAND PRAIRIE, TX 75051-3852
(972) 606-4858
(972) 606-1637
Mailing address
166 RANCHWAY DR, BURLESON, TX 76028-7864
(817) 426-5439
(972) 606-1637
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
660120001
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y947
MEDICARE PTAN
TX
Enumeration date
02/09/2007
Last updated
12/31/2008
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