| NPI | 1013452176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAO TRAN Owner 855-633-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40qa01105400) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40qa01103700) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |