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Organization
PAMELA ROUSSELL PHYSICAL THERAPY AND WELLNESS
Active
Organization
PAMELA ROUSSELL PHYSICAL THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA MARIE ROUSSELL PT (PHYSICAL THERAPIST PRACTICE OWNER)
(732) 842-9100
Entity
Organization
Contact information
Practice address
354 CONOVER PLACE, RED BANK, NJ 07701
(732) 842-9100
Mailing address
354 CONOVER PLACE, RED BANK, NJ 07701
(732) 842-9100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
QA05714
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00011543
RAILROAD MEDICARE
—
Enumeration date
03/06/2007
Last updated
08/22/2020
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