Provider Demographics
NPI:1215278437
Name:COMPASS PHYSICAL THERAPY SPECIALISTS
Entity type:Organization
Organization Name:COMPASS PHYSICAL THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:JAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:269-203-7385
Mailing Address - Street 1:3623 GLENGARRY AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-3124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8801 N 32ND ST
Practice Address - Street 2:SUITE 2-A
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-8567
Practice Address - Country:US
Practice Address - Phone:269-203-7385
Practice Address - Fax:269-216-7634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy