| NPI | 1841701141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY BOYD Owner/CEO 856-347-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA01529700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01529700) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01529700) | |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2021-03-15 |