MEDICARE: COMPLETE PHYSICAL THERAPY INC

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	225100000X	Physical Therapist	7846	AZ

General Provider Information

NPI Number	:	1548431075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	4110 N 108TH AVE STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5772
Country	:	US
Telephone Number	:	623-877-9915
Fax Number	:

Provider Business Practice Location Address
First Line	:	4110 N 108TH AVE STE 103
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5772
Country	:	US
Telephone Number	:	623-877-9915
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER PODBIELSKI
Credential	:	PT
Telephone Number	:	623-877-9915

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	02/03/2010

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