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General NPI Number Information
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NPI Number | 1215278437
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Entity Type | Organization
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Legal Business Name | COMPASS PHYSICAL THERAPY SPECIALISTS
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 8801 N 32ND ST SUITE 2-A
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City | RICHLAND
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State | MI
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Zip | 49083-8567
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Country | US
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Telephone | 269-203-7385
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Fax | 269-216-7634
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Provider Business Mailing Address
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Address Line | 3623 GLENGARRY AVE
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City | KALAMAZOO
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State | MI
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Zip | 49004-3124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRAVIS RYAN JAGER
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Credential | P.T.
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Telephone | 269-203-7385
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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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