| NPI | 1417021841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR FANO President 908-851-2666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA07067900) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00493100) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-09-16 |