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Organization
PRIME PAIN CLINIC P.C.
Active
Organization
PRIME PAIN CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAE SIK RA RPT (OWNER)
(201) 313-1122
Entity
Organization
Contact information
Practice address
118 BROAD AVE, STE N10, PALISADES PARK, NJ 07650
(201) 313-1122
(201) 941-1157
Mailing address
118 BROAD AVE SUITE N10, PALISADES PARK, NJ 07650
(201) 313-1122
(201) 941-1157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/16/2014
Last updated
12/22/2016
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