NPI | 1437652476 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL DERILO MIRABUENO President 732-407-6308 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01300700) |
Additional Taxonomies | 111N00000X Chiropractor |
171100000X Acupuncturist | |
Enumeration Date | 2018-03-15 |
Last Update Date | 2022-07-22 |