| NPI | 1912416959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY BODNER Owner/Md 732-333-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB08845000) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2022-09-12 |