Provider Demographics
NPI:1609621721
Name:COMPLETE RECOVERY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:COMPLETE RECOVERY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGHBIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-970-0047
Mailing Address - Street 1:24680 SWANSON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2415
Mailing Address - Country:US
Mailing Address - Phone:313-970-0047
Mailing Address - Fax:
Practice Address - Street 1:24680 SWANSON RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2415
Practice Address - Country:US
Practice Address - Phone:313-970-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty