| NPI | 1225019805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GREGORY VIDAL Owner/Physical Therapist 856-424-0993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2020-08-22 |