| NPI | 1124108782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LUIS GONZALEZ Owner 732-544-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00616100) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2014-03-11 |