Provider Demographics
NPI:1891039632
Name:COMPLETE HOMETOWN PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:COMPLETE HOMETOWN PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:CHANCE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-393-4100
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-0248
Mailing Address - Country:US
Mailing Address - Phone:512-743-1580
Mailing Address - Fax:361-238-5000
Practice Address - Street 1:203 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-2729
Practice Address - Country:US
Practice Address - Phone:512-393-4100
Practice Address - Fax:361-238-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty