| NPI | 1699822015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA RENEE JACOB Billing Manager 856-751-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA0696300) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: NJ 40QA00982700) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2018-06-21 |