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NPI Code Detail

MEDICARE: COMPREHENSIVE PHYSICAL THERAPY, INC

MEDICARE: COMPREHENSIVE 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
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1679546113
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE PHYSICAL THERAPY, INC
Provider Business Mailing Address
First Line : 97 BEECH GROVE RD
Second Line :
City : HONESDALE
State : PA
Zip : 18431-4164
Country : US
Telephone Number : 570-253-5615
Fax Number :
Provider Business Practice Location Address
First Line : 354 MAIN ST
Second Line :
City : FOREST CITY
State : PA
Zip : 18421-1418
Country : US
Telephone Number : 570-785-2018
Fax Number : 570-785-2061
Authorized Official
Title or Position : OWNER
Name : MR. STEPHEN ATCAVAGE
Credential : DPT
Telephone Number : 570-785-2018
Provider Enumeration Date : 02/07/2006
Last Update Date : 02/20/2020

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Directions to “COMPREHENSIVE PHYSICAL THERAPY, INC ” Practice Location

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