Basic Information
| Provider Information | |||||||||
| NPI: | 1770892390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEEK | ||||||||
| FirstName: | LORI | ||||||||
| MiddleName: | ELISE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 JULIAN LANE | ||||||||
| Address2: | SUITE 660 | ||||||||
| City: | ARDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287047813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286843611 | ||||||||
| FaxNumber: | 8286843611 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 JULIAN LN | ||||||||
| Address2: | SUITE 660 | ||||||||
| City: | ARDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287047813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286843611 | ||||||||
| FaxNumber: | 8286843611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2010 | ||||||||
| LastUpdateDate: | 09/30/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 12830 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.