Provider Demographics
NPI:1386605137
Name:COMPREHENSIVE SPORTS CARE SPECIALISTS INC
Entity type:Organization
Organization Name:COMPREHENSIVE SPORTS CARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-497-9758
Mailing Address - Street 1:121 FRIENDS LANE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-497-9758
Mailing Address - Fax:215-497-9759
Practice Address - Street 1:121 FRIENDS LANE
Practice Address - Street 2:SUITE 700
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-497-9758
Practice Address - Fax:215-497-9759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
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
PA061160Medicare ID - Type Unspecified