BO BLAINE GUMALO

HACKENSACK, NJ
NPI1083263982
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: NJ  40QA01873000)
Enumeration Date2019-09-04
Last Update Date2019-09-04
Business Address
BO BLAINE GUMALO PT, DPT
605 MAIN ST
HACKENSACK, NJ 07601-5914
Phone number: 201-488-0488
Mailing Address
BO BLAINE GUMALO PT, DPT
605 MAIN ST
HACKENSACK, NJ 07601-5914
Phone number: 201-488-0488