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General NPI Number Information
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NPI Number | 1194902817
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 06/20/2012
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Provider Practice Location Address
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Address Line | 37104 CLINTON AVE
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City | DADE CITY
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State | FL
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Zip | 33525-5911
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Country | US
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Telephone | 352-521-0627
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Fax | 352-521-5958
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Provider Business Mailing Address
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Address Line | PO BOX 1001
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City | DADE CITY
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State | FL
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Zip | 33526-1001
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Country | US
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Telephone | 352-521-0627
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Fax | 352-521-5958
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBORAH A KNICKERBOCKER
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Credential |
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Telephone | 352-521-0627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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