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1780735316
MICHAEL EVANGELIST
WEST ORANGE, NJ
NPI
1780735316
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA01129500)
Enumeration Date
2007-01-12
Last Update Date
2007-07-08
Business Address
-- MICHAEL EVANGELIST MSPT
622 EAGLE ROCK AVE
WEST ORANGE, NJ 07052-2994
Phone number: 973-669-0078
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Mailing Address
-- MICHAEL EVANGELIST MSPT
715 CLINTON ST APT 17
HOBOKEN, NJ 07030-2841
Phone number: 973-669-0078
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