Organization
PEAK PERFORMANCE PHYSICAL THERAPY, PC
Active
Other names
Peak Performance Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA JACOBSEN TIDSWELL PT, DPT, SCS, ATC (PRESIDENT)
(801) 718-5378
Entity
Organization
Contact information
Practice address
2760 RASMUSSEN RD, D2-D3, PARK CITY, UT 84098-5684
(801) 718-5378
Mailing address
515 ASPEN DRIVE, PARK CITY, UT 84098
(801) 718-5378
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5080663-2401
UT
Other
Enumeration date
04/18/2014
Last updated
05/01/2014
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