# ACTIVITY FIRST PHYSICAL THERAPY AND SPORTS MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124108782
- **Authorized official:** MR. KEVIN LUIS GONZALEZ P.T. (OWNER)
- **Authorized official phone:** (732) 544-0007

## Contact information

- **Practice address:** 158 WYCKOFF RD, EATONTOWN, NJ 07724-1840
- **Practice address phone:** (732) 544-0007
- **Practice address fax:** (732) 544-0008
- **Mailing address:** 158 WYCKOFF RD, EATONTOWN, NJ 07724-1840
- **Mailing address phone:** (732) 544-0007
- **Mailing address fax:** (732) 544-0008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA00616100 | NJ | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 03/11/2014