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1275201394
JAKE GROOTENBOER
PARAMUS, NJ
NPI
1275201394
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA02030000)
Enumeration Date
2021-09-02
Last Update Date
2024-08-15
Business Address
JAKE GROOTENBOER P.T.
776 N RTE 17
PARAMUS, NJ 07652-3117
Phone number: 201-225-9222
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Mailing Address
JAKE GROOTENBOER P.T.
331 NEWMAN SPRINGS RD STE 220
RED BANK, NJ 07701-5792
Phone number: 732-807-0877
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