| NPI | 1083339550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA EVANS Owner 201-306-5565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2024-05-13 |