| NPI | 1629335997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON PARK President 201-602-9726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01425200) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |