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Organization
PROFORM PHYSICAL THERAPY LLC
Active
Organization
PROFORM PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD JESUS SOMARRIBA PT (OWNER)
(732) 770-7882
Entity
Organization
Contact information
Practice address
510 ROUTE 18, EAST BRUNSWICK, NJ 08816-3092
(732) 970-7882
(732) 970-7883
Mailing address
1212 HIGHWAY 34 STE 24-25, ABERDEEN, NJ 07747-1903
(732) 970-7882
(732) 970-7883
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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