# PEAK FORM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peak Form Medical Clinic, Peak Form Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982718003
- **Authorized official:** JEANETTE HRUBES (CLINIC DIRECTOR)
- **Authorized official phone:** (720) 939-1058

## Contact information

- **Practice address:** 695 S BROADWAY ST STE A, BOULDER, CO 80305-5925
- **Practice address phone:** (303) 402-9283
- **Practice address fax:** (303) 494-1251
- **Mailing address:** 1093 E BRIDGE ST, BRIGHTON, CO 80601-2252
- **Mailing address phone:** (303) 655-9005
- **Mailing address fax:** (303) 655-0063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 224Y00000X | Clinical Exercise Physiologist | — | NULL | — |
| 224Y00000X | Clinical Exercise Physiologist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LX0106X | Occupational Health Nurse Practitioner | — | NULL | — |
| 363LX0106X | Occupational Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 07/31/2020