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Organization

PHYSICAL THERAPY COMPLETE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL JOHN GLEASON P.T. (OWNER/MEMBER)
(602) 264-5323
Entity
Organization

Contact information

Practice address
375 E VIRGINIA AVE, SUITE B, PHOENIX, AZ 85004-1220
(602) 264-5323
(602) 264-5302
Mailing address
375 E VIRGINIA AVE, SUITE B, PHOENIX, AZ 85004-1220
(602) 264-5323
(602) 264-5302

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2Z1876
HEALTHNET PROVIDER ID
AZ
01
8145185
AETNA PROVIDER ID
AZ
05
854184
AZ
01
P0460470
BCBS OF ARIZONA
AZ
Enumeration date
03/03/2006
Last updated
11/27/2007
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