# MOORESTOWN SPINE SPORTS AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Concierge Spine and Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659075026
- **Authorized official:** DR. MALINI M KHANNA MD (PRESIDENT/CEO)
- **Authorized official phone:** (202) 262-5629

## Contact information

- **Practice address:** 201 WHITE HORSE RD E, VOORHEES, NJ 08043-2601
- **Practice address phone:** (856) 661-7900
- **Practice address fax:** (856) 250-1464
- **Mailing address:** 200 MARTER AVE STE 700, MOORESTOWN, NJ 08057-3147
- **Mailing address phone:** (856) 661-7900
- **Mailing address fax:** (856) 250-1464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |

## Other

- **Enumeration date:** 03/29/2023
- **Last updated:** 05/30/2023