Provider Demographics
NPI:1639331770
Name:COMPLETE P T POOL AND LAND PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:COMPLETE P T POOL AND LAND PHYSICAL THERAPY INC
Other - Org Name:COMPLETE PT INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-845-9690
Mailing Address - Street 1:3283 MOTOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3709
Mailing Address - Country:US
Mailing Address - Phone:310-845-9690
Mailing Address - Fax:310-845-9691
Practice Address - Street 1:3283 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3709
Practice Address - Country:US
Practice Address - Phone:310-845-9690
Practice Address - Fax:310-845-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000097831600016261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy