| NPI | 1386843522 |
|---|---|
| Former Legal Business Name | 123 PHYSICAL THERAPY, LLC |
| Entity Type | Organization |
| Authorized Contact | VIVIAN RODRIGUEZ Office Manager 201-758-5238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2014-12-09 |