Provider Demographics
NPI:1548431075
Name:COMPLETE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:COMPLETE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:PODBIELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:623-877-9915
Mailing Address - Street 1:4110 N 108TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5772
Mailing Address - Country:US
Mailing Address - Phone:623-877-9915
Mailing Address - Fax:
Practice Address - Street 1:4110 N 108TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5772
Practice Address - Country:US
Practice Address - Phone:623-877-9915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty