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Organization
SPARTA ORTHOPEDIC & SPORTS PHYSICAL THERAPY LLC
Active
Organization
SPARTA ORTHOPEDIC & SPORTS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT C THEURET RPT (PRESIDENT PHYSICAL THERAPIST)
(973) 726-0111
Entity
Organization
Contact information
Practice address
57 SPARTA AVE, SPARTA, NJ 07871-1822
(973) 726-0111
(973) 726-0399
Mailing address
57 SPARTA AVE, SPARTA, NJ 07871-1822
(973) 726-0111
(973) 726-0399
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01006600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611366300
DEPARTMENT OF LABOR
NJ
Enumeration date
09/29/2006
Last updated
07/28/2016
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