| NPI | 1104199918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI WILLE Owner/President 862-266-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: NJ 40QA00586800) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |