Organization
PINE PEAK THERAPY LLC
Active
Other names
Pine Peak Audiology
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY ALICE VIG OTR/L (OCCUPATIONAL THERAPIST)
(218) 435-1210
Entity
Organization
Contact information
Practice address
903 HILLIGOSS BLVD SE, FOSSTON, MN 56542-1541
(218) 435-1210
(218) 435-1175
Mailing address
PO BOX 300, FOSSTON, MN 56542-0300
(218) 435-1210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/31/2023
Last updated
06/10/2025
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