Provider Demographics
NPI:1780292052
Name:COMPREHENSIVE THERAPY & REHAB
Entity type:Organization
Organization Name:COMPREHENSIVE THERAPY & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFICATION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:TEEL
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:706-491-0771
Mailing Address - Street 1:330 RESEARCH DR STE 110
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-2759
Mailing Address - Country:US
Mailing Address - Phone:706-254-2000
Mailing Address - Fax:844-965-9643
Practice Address - Street 1:306 LAURENS ST NW STE A&B
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3968
Practice Address - Country:US
Practice Address - Phone:706-491-0771
Practice Address - Fax:844-965-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
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
00000000OtherDEEOICP