Provider Demographics
NPI: | 1871307496 |
---|---|
Name: | PEAK & BOUNDS INCORPORATED |
Entity type: | Organization |
Organization Name: | PEAK & BOUNDS INCORPORATED |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EMILY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TULL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR/L |
Authorized Official - Phone: | 757-897-2839 |
Mailing Address - Street 1: | 3416 KILLARNEY CT |
Mailing Address - Street 2: | |
Mailing Address - City: | LAPORTE |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80535-9337 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 757-897-2839 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3416 KILLARNEY CT |
Practice Address - Street 2: | |
Practice Address - City: | LAPORTE |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80535-9337 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-897-2839 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | PEAKS & BOUNDS INCORPORATED |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2025-02-04 |
Last Update Date: | 2025-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty |