MEDICARE: COMFORD PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1306592134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMFORD PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	2459 UNIVERSITY COMMONS WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5585
Country	:	US
Telephone Number	:	619-277-8454
Fax Number	:

Provider Business Practice Location Address
First Line	:	2459 UNIVERSITY COMMONS WAY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5585
Country	:	US
Telephone Number	:	619-277-8454
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TAYLOR COMFORD
Credential	:	PT DPT OCS SCS
Telephone Number	:	619-277-8454

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	03/02/2022

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