| NPI | 1710039623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DE LA FUENTE Physical Therapist, President 732-499-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01170400) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01170400) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-10-26 |