Provider Demographics
NPI:1811796121
Name:TURCK, PETER JOSEPH
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:TURCK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 GRETCHEN CT
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:VA
Mailing Address - Zip Code:24179-3307
Mailing Address - Country:US
Mailing Address - Phone:540-392-3162
Mailing Address - Fax:
Practice Address - Street 1:109 GRETCHEN CT
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:VA
Practice Address - Zip Code:24179-3307
Practice Address - Country:US
Practice Address - Phone:540-392-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT63046590343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)