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1003984451
GINA OTILIA HEREDEA
FORT LEE, NJ
NPI
1003984451
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA01089000)
Enumeration Date
2006-12-02
Last Update Date
2007-07-08
Business Address
Miss GINA OTILIA HEREDEA P.T.
6 HORIZON RD APT 512
FORT LEE, NJ 07024-6606
Phone number: 551-221-0660
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Mailing Address
Miss GINA OTILIA HEREDEA P.T.
6 HORIZON RD APT 512
FORT LEE, NJ 07024-6606
Phone number: 551-221-0660
Copy
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