Provider Demographics
NPI:1306592134
Name:COMFORD PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:COMFORD PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:COMFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT OCS SCS
Authorized Official - Phone:619-277-8454
Mailing Address - Street 1:2459 UNIVERSITY COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5585
Mailing Address - Country:US
Mailing Address - Phone:619-277-8454
Mailing Address - Fax:
Practice Address - Street 1:2459 UNIVERSITY COMMONS WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5585
Practice Address - Country:US
Practice Address - Phone:619-277-8454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation