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Organization
MCM PT SERVICE
Active
Organization
MCM PT SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA SPEARS (OFFICE MANAGER)
(732) 741-0678
Entity
Organization
Contact information
Practice address
130 MAPLE AVE, SUITE 4A, RED BANK, NJ 07701-1734
(732) 741-0678
Mailing address
130 MAPLE AVE, SUITE 4A, RED BANK, NJ 07701-1734
(732) 741-0678
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA00369200
NJ
225100000X
Physical Therapist
Primary
40QA00544800
NJ
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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