Provider Demographics
NPI:1053922856
Name:COMPLEAT REHAB & SPORTS THERAPY CENTER
Entity type:Organization
Organization Name:COMPLEAT REHAB & SPORTS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-747-2409
Mailing Address - Street 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:704-747-2409
Mailing Address - Fax:
Practice Address - Street 1:197 PIEDMONT BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1846
Practice Address - Country:US
Practice Address - Phone:704-747-2409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPLEAT REHAB & SPORTS THERAPY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health