| 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 |