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Organization
REVELATION THERAPY HEALTH SERVICES
Active
Organization
REVELATION THERAPY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIBISAY R NISBETT (OWNER)
(862) 452-6086
Entity
Organization
Contact information
Practice address
115 EVERGREEN PL, EAST ORANGE, NJ 07018-2006
(862) 452-6086
(973) 677-1655
Mailing address
840 S 13TH ST, NEWARK, NJ 07108-1316
(862) 452-6086
(973) 374-4494
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
401OA01008800
NJ
Other
Enumeration date
08/05/2006
Last updated
08/22/2020
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