# EDGE PHYSICAL THERAPY AND SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1467828301
- **Authorized official:** DR. LAWRENCE KIM PT, DPT, OCS (MANAGING DIRECTOR)
- **Authorized official phone:** (201) 783-2332

## Contact information

- **Practice address:** 407 SETTE DR, PARAMUS, NJ 07652-2940
- **Practice address phone:** (201) 783-2332
- **Mailing address:** 407 SETTE DR, PARAMUS, NJ 07652-2940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 40QA01510100 | NJ | Yes |

## Other

- **Enumeration date:** 08/14/2015
- **Last updated:** 08/14/2015