Provider Demographics
NPI:1760880298
Name:DPTI-PEAK REHAB LLC
Entity type:Organization
Organization Name:DPTI-PEAK REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:1902 SE WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-6736
Mailing Address - Country:US
Mailing Address - Phone:918-876-1482
Mailing Address - Fax:918-876-1506
Practice Address - Street 1:1902 SE WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-6736
Practice Address - Country:US
Practice Address - Phone:918-876-1482
Practice Address - Fax:918-876-1506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty