| NPI | 1790292936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MALLON Physical Therapist 856-237-4703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251S0007X Physical Therapist, Sports | |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |