| NPI | 1104203330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRATHIBHA GOTTUMUKKALA Physical Therapist 732-609-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01534600) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2015-10-19 |