| NPI | 1376989194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANA JOHNSON Administrator 973-414-1357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01110500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00987800) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |