Peak Function Physical Therapy and Sports Performance

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PEAK FUNCTION PHYSICAL THERAPY AND SPORTS PERFORMANCE

Practice address

16285 Pomona Drive
Redford, MI 48240

Phone

(248) 533-5318

NPI assigned

Aug 14, 2019

Last updated

Aug 14, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenna Pack, PT, DPT

Title

Owner/Physical Therapist

Phone

(248) 533-5318

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1134775240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18701 GRAND RIVER AVE STE 115",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16285 POMONA DRIVE",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "48240",
            "telephone_number": "248-533-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK FUNCTION PHYSICAL THERAPY AND SPORTS PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "PACK",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "248-533-5318",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Redford, MI
• Providers in Redford, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.