| NPI | 1750861365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE DAVID HERRICK Owner 973-800-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: NJ 40QA01562000) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: NJ 41YS00937900) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2020-12-01 |