Provider Demographics
NPI:1255479101
Name:COMPREHENSIVE PHYSICAL THERAPY AND FITNESS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PHYSICAL THERAPY AND FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-997-1160
Mailing Address - Street 1:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-0342
Mailing Address - Country:US
Mailing Address - Phone:215-997-1160
Mailing Address - Fax:215-997-3798
Practice Address - Street 1:2621 N BROAD ST
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915-9401
Practice Address - Country:US
Practice Address - Phone:215-997-1160
Practice Address - Fax:215-997-3798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty