Provider Demographics
NPI:1558555805
Name:COMPLETE CARE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:COMPLETE CARE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-796-0303
Mailing Address - Street 1:P.O. BOX 638329
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8329
Mailing Address - Country:US
Mailing Address - Phone:419-873-3488
Mailing Address - Fax:419-873-4777
Practice Address - Street 1:27511 HOLIDAY LN
Practice Address - Street 2:STE 105
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5397
Practice Address - Country:US
Practice Address - Phone:419-873-3488
Practice Address - Fax:419-873-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy