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Organization
SPORTSMED OF GLEN ROCK PA
Active
Organization
SPORTSMED OF GLEN ROCK PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT KHALAF (MANAGING OFFICER)
(201) 803-7695
Entity
Organization
Contact information
Practice address
266 HARRISTOWN RD, SUITE 200, GLEN ROCK, NJ 07452-3302
(201) 803-7695
Mailing address
266 HARRISTOWN RD, SUITE 200, GLEN ROCK, NJ 07452-3302
(201) 803-7695
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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