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Organization
PATAGONIA FITNESS LLC
Active
Organization
PATAGONIA FITNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCO CHIABO PT, DPT, COMT (OWNER)
(551) 486-6157
Entity
Organization
Contact information
Practice address
201 MARIN BLVD APT 307, JERSEY CITY, NJ 07302-6492
(551) 486-6157
Mailing address
201 MARIN BLVD APT 307, JERSEY CITY, NJ 07302-6492
(551) 486-6157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
029622
NY
225100000X
Physical Therapist
Primary
0400319126
NJ
225100000X
Physical Therapist
40QA01345700
NJ
Other
Enumeration date
06/30/2017
Last updated
07/21/2022
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