| NPI | 1487390977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYLAN CHURCH Co Owner/Athletic Trainer 908-239-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-05-09 |