Provider Demographics
NPI:1255332581
Name:COMPWHIZ INTERNATIONAL LLC
Entity Type:Organization
Organization Name:COMPWHIZ INTERNATIONAL LLC
Other - Org Name:ST. LUKE'S THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:CEDRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:MANALILI
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:423-317-7955
Mailing Address - Street 1:901 E MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2499
Mailing Address - Country:US
Mailing Address - Phone:423-586-6866
Mailing Address - Fax:423-581-9679
Practice Address - Street 1:1907 W MORRIS BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3860
Practice Address - Country:US
Practice Address - Phone:423-317-7955
Practice Address - Fax:423-317-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718146Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPY
TN3654705Medicare ID - Type UnspecifiedPHYSICAL THERAPY