Healthcare Provider Details

I. General information

NPI: 1255332581
Provider Name (Legal Business Name): COMPWHIZ INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 W MORRIS BLVD SUITE E
MORRISTOWN TN
37813-3860
US

IV. Provider business mailing address

901 E MORRIS BLVD
MORRISTOWN TN
37813-2499
US

V. Phone/Fax

Practice location:
  • Phone: 423-317-7955
  • Fax: 423-317-7977
Mailing address:
  • Phone: 423-586-6866
  • Fax: 423-581-9679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CEDRICK E MANALILI
Title or Position: OWNER/PT
Credential: PHYSICAL THERAPIST
Phone: 423-317-7955