| NPI | 1912076126 |
|---|---|
| Doing Business As | ON TRACE REHABILITATION |
| Entity Type | Organization |
| Authorized Contact | DAVID R MOORE Owner 973-253-7005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00543200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01158600) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |