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Organization
MTB FIRST ASSIST LLC
Active
Organization
MTB FIRST ASSIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TYLER BOOTH PA (OWNER)
(973) 738-0627
Entity
Organization
Contact information
Practice address
136 BALL RD, MOUNTAIN LAKES, NJ 07046-1625
(973) 738-0627
Mailing address
136 BALL RD, MOUNTAIN LAKES, NJ 07046-1625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NULL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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