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Organization
TRI COUNTY HOME THERAPY LLC
Active
Organization
TRI COUNTY HOME THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DONNELLY PT (OWNER)
(856) 305-4268
Entity
Organization
Contact information
Practice address
313 BEEBE RUN RD, BRIDGETON, NJ 08302-5680
(856) 305-4268
(856) 697-0071
Mailing address
313 BEEBE RUN RD, BRIDGETON, NJ 08302-5680
(856) 305-4268
(856) 697-0071
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00566300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40QA00566300
LICENSE
NJ
Enumeration date
09/28/2007
Last updated
09/28/2007
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