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General NPI Number Information
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NPI Number | 1780915181
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PAIN RELIEF INC.
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 305 COMMERCE CENTER DR
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1549
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Country | US
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Telephone | 407-556-3905
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Fax | 407-556-3906
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Provider Business Mailing Address
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Address Line | 305 COMMERCE CENTER DR
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City | SAINT CLOUD
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State | FL
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Zip | 34769-1549
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Country | US
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Telephone | 407-556-3905
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Fax | 407-556-3906
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Authorized Official
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Title or Position | PHYSICAL THERAPIST / PRESIDENT
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Name | RUTH M PANDOLPH
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Credential | PT
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Telephone | 407-556-3905
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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 | PT10579
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License Number State | FL
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