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1043999196
FORM FUNCTIONAL HEALTH LLC
RIDGEWOOD, NJ
NPI
1043999196
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Entity Type
Organization
Authorized Contact
RAFFAELE LAGONIGRO
Owner
973-464-6356
Organization Subpart ?
No
Primary Taxonomy
261QP2000X Clinic/Center, Physical Therapy
Enumeration Date
2023-07-17
Last Update Date
2024-04-12
Business Address
FORM FUNCTIONAL HEALTH LLC
15 GODWIN AVE STE 1
RIDGEWOOD, NJ 07450-3739
Phone number: 973-841-4800
Copy
Mailing Address
FORM FUNCTIONAL HEALTH LLC
15 GODWIN AVE STE 1
RIDGEWOOD, NJ 07450-3739
Phone number: 973-841-4800
Copy
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