Provider Demographics
NPI:1447496724
Name:PEAKSIDE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PEAKSIDE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-401-7610
Mailing Address - Street 1:1010 SE 6TH PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-3906
Mailing Address - Country:US
Mailing Address - Phone:352-401-7610
Mailing Address - Fax:352-438-0047
Practice Address - Street 1:3845 SE LAKE WEIR AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-9153
Practice Address - Country:US
Practice Address - Phone:352-401-7610
Practice Address - Fax:352-438-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18846261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy