Complete Physical Therapy & Diagnostic Center, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

026300 Issued in GA

Legal business name

COMPLETE PHYSICAL THERAPY & DIAGNOSTIC CENTER, LLC

Practice address

555 Old Norcross Rd
Suite 100
Lawrenceville, GA 30045-8716

Phone

(770) 822-3031

Fax

(770) 822-3032

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Renee Leclair

Title

Office Manager

Phone

(770) 822-3031

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548388697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458716",
            "telephone_number": "770-822-3031",
            "fax_number": "770-822-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458716",
            "telephone_number": "770-822-3031",
            "fax_number": "770-822-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PHYSICAL THERAPY & DIAGNOSTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LECLAIR",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-822-3031"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "026300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.