Organization
COMPREHENSIVE PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH A KNICKERBOCKER (ADMINISTRATOR)
(352) 521-0627
Entity
Organization
Contact information
Practice address
37104 CLINTON AVE, DADE CITY, FL 33525-5911
(352) 521-0627
(352) 521-5958
Mailing address
PO BOX 1001, DADE CITY, FL 33526-1001
(352) 521-0627
(352) 521-5958
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT3564
STATE OF FLORIDA
FL
Enumeration date
01/24/2008
Last updated
06/20/2012
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