| NPI | 1518017144 |
|---|---|
| Former Legal Business Name | JAG PHYSICAL THERAPY LLC |
| Entity Type | Organization |
| Authorized Contact | JOHN ANTHONY GALLUCCI Owner 973-669-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01172700) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2019-08-06 |