Organization
PEAK PERFORMANCE PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI ANN TJELTA PT/ATC (PRESIDENT/OWNER)
(701) 947-2030
Entity
Organization
Contact information
Practice address
207 1ST AVE S, SUITE C, NEW ROCKFORD, ND 58356-1800
(701) 947-2030
Mailing address
207 1ST AVE S STE C, NEW ROCKFORD, ND 58356-1800
(701) 947-2030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20793500
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55080
—
ND
Enumeration date
10/11/2006
Last updated
04/26/2011
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