Basic Information
| Provider Information | |||||||||
| NPI: | 1285611467 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPREHENSIVE PHYSICAL THERAPY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1037 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEICESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015241313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088921335 | ||||||||
| FaxNumber: | 5088921780 | ||||||||
| Practice Location | |||||||||
| Address1: | 1037 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEICESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015241313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088921335 | ||||||||
| FaxNumber: | 5088921780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 09/18/2014 | ||||||||
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| AuthorizedOfficialLastName: | BUZZELL | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5088921335 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.