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General NPI Number Information
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NPI Number | 1538123682
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PHYSICAL THERAPY CARE
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 1221 W STRATFORD RD
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City | AVON PARK
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State | FL
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Zip | 33825-8091
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Country | US
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Telephone | 863-453-3701
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Fax |
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Provider Business Mailing Address
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Address Line | 4517 PEBBLE BEACH DR
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City | SEBRING
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State | FL
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Zip | 33872-1731
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Country | US
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Telephone | 863-453-3701
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROWENA BADENHORST
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Credential | P.T.
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Telephone | 863-453-3701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT0010746
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License Number State | FL
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