Pine Peak Therapy LLC
NPI 1982477030ActiveOrganization· Physical Therapist· Fosston, MN
Physical Therapist in Fosston, Minnesota, registered in NPPES in October 2023. The authorized official on file is Mallory Alice Vig, OTR/L, Occupational Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1982477030 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 31, 2023 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Audiologist | 231H00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
Other physical therapists in Fosston
- 1164984647
- 1538588579
- 1336074574