Provider Demographics
NPI:1356802698
Name:COMPLETE WELLNESS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:COMPLETE WELLNESS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YULIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHMAZOV
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:267-832-7911
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-6187
Mailing Address - Country:US
Mailing Address - Phone:267-832-7911
Mailing Address - Fax:267-363-7131
Practice Address - Street 1:17 BARCLAY ST
Practice Address - Street 2:BUILDING A/B
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:267-832-7911
Practice Address - Fax:267-363-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy