| NPI | 1255664355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALDO PORTUGUEZ Manager 609-233-5056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01095400) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-09-08 |