Provider Demographics
NPI:1770664724
Name:COMPREHENSIVE PHYSICAL THERAPY CENTER INC
Entity type:Organization
Organization Name:COMPREHENSIVE PHYSICAL THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DIANGELIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:513-576-6338
Mailing Address - Street 1:970 LILA AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1683
Mailing Address - Country:US
Mailing Address - Phone:513-576-6338
Mailing Address - Fax:513-576-6340
Practice Address - Street 1:970 LILA AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1683
Practice Address - Country:US
Practice Address - Phone:513-576-6338
Practice Address - Fax:513-576-6340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH36-6670Medicare ID - Type Unspecified