| NPI | 1023158433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERWIN RENEGADO BANDALES Physical Therapist Owner 973-773-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00655900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00672700) |
| 225100000X Physical Therapist (Licence: NJ 40QA01013300) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |