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Organization
TREVOR FENNELL PHYSICAL THERAPY CORP
Active
Organization
TREVOR FENNELL PHYSICAL THERAPY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR FENNELL (OWNER)
(845) 222-9394
Entity
Organization
Contact information
Practice address
18 ELMWOOD AVE, HO HO KUS, NJ 07423-1530
(845) 222-9394
(801) 336-9639
Mailing address
18 ELMWOOD AVE, HO HO KUS, NJ 07423-1530
(845) 222-9394
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619904125
NPI
NJ
Enumeration date
05/06/2020
Last updated
07/06/2020
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