| NPI | 1891064846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL P WILLEMSE Owner 908-349-0342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NJ 38MC00689200) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 111N00000X Chiropractor | |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2022-03-18 |