Complete Physical Therapy and Wellness, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3934 Issued in TN

Legal business name

COMPLETE PHYSICAL THERAPY AND WELLNESS, LLC

Practice address

1633 W Main St
Lebanon, TN 37087-3423

Phone

(615) 504-6853

NPI assigned

Feb 24, 2012

Organization subpart

No

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

Authorized official

Name

Michael W Davidson, BSPT

Title

Provider

Phone

(615) 504-6853

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1699049593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873423",
            "telephone_number": "615-504-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 W MAIN ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873423",
            "telephone_number": "615-504-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "615-504-6853",
        "authorized_official_credential": "BSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "3934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.