Healthcare Provider Details

I. General information

NPI: 1720785132
Provider Name (Legal Business Name): COMPLETE MOTION THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 1ST ST N
CASSELTON ND
58012-3305
US

IV. Provider business mailing address

PO BOX 1074
CASSELTON ND
58012-1074
US

V. Phone/Fax

Practice location:
  • Phone: 701-346-0222
  • Fax: 701-346-0223
Mailing address:
  • Phone: 701-346-0222
  • Fax: 701-346-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA GUNKEL
Title or Position: GENERAL PARTNER, PHYSICAL THERAPIST
Credential: PT
Phone: 701-367-8682